Team-Based Medicine: The Patient-Centered Medical Home
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The Patient-Centered Medical Home
Gone are the days of the private physician office tucked quietly away from the center of the clinic; now the center of the clinic is where the work and collaboration takes place. The Patient-Centered Medical Home (PCMH) reorganizes how primary care is structured and delivered. From simple problems to multiple chronic conditions, the philosophy is to form a partnership among the patient, his or her healthcare provider, and his or her family to ensure the patient receives the necessary care when and where it is needed.
Five characteristics of PCMH:
Newport Health Center - NAC Architecture
Benefits of PCMH
  1. Engaged, happier, and more satisfied patients
  2. Better coordinated, more comprehensive and personalized care
  3. Improved access to medical care and services
  4. Improved health outcomes, especially for patients who have chronic conditions
  1. Joy in practice: increased physician and staff satisfaction
  2. Physicians and staff are more efficient and flexible
  3. Improved safety and quality of care
  1. More efficient use of practice resources, resulting in cost savings
  2. Operational efficiencies
  3. A practice that is better prepared for a value-based payment system
Tailoring the Workplace for PCMH
With team-based medicine, the center of the clinic is where the work and collaboration takes place. A community space needs to be created to support the team where open communication and team integration can take place. Not only will this community space house a workstation for the provider and his or her MA, but this is where all members of the team should have their workstations, including Patient Care Coordinator, social worker, behavioral health, and stations for specialists and ancillary services, such as visiting physicians, PT/OT, nutritionists, etc.
Because technology plays such a strong role in the PCMH, it is imperative to include training space for staff. This allows for easy access to a space for learning new processes and technologies without having staff leave the clinic. This space can also be used for group patient visits and patient education.
Clearwater Valley Medical Center - NAC Architecture
It is also important to build in off-stage areas for staff to exit the patient areas and have a comfortable space with views to the exterior in order to recharge. Typically this is the staff break room, but can also include staff quiet rooms and exterior gardens.
Newport Health Center - NAC Architecture
The most critical design element for a PCMH is to ensure the exam rooms are large enough to accommodate not only the patient and family members, but also the different members of the patient care team to be in the room at the same time. With team-based medicine, the exam room is not just for examinations, but rather it should be considered a care space for the patient and the team.