From the Director
When I'm asked about the future, I often say my crystal ball is a bit cloudy. But when people want to know about the need for primary care to change, my crystal ball is clear.
As a general internist who has spent much of my career in primary care practice, I take a special interest in payment reform, workforce development, building an infrastructure for primary care, and care coordination. Each of these activities is critical and contributes to success of the others. One strategy that can impact all these areas is practice facilitation.
As we move toward a medical home model of primary care, some primary care practices are beginning to not only change and grow—but thrive—by working with practice facilitators. These professionals, sometimes called coaches or enhancement assistants, build relationships with practices to help them become fertile for changes to redesign practices and incorporate best clinical practices and best management practices into daily clinic operations.
Facilitators typically work with a variety of practices in a geographic area, sharing ideas that have worked in other locations and making specific suggestions. Although facilitators focus primarily on helping primary care practices become medical homes, they also help practices with general quality improvement and redesign efforts. They tend to be people who like to teach and are service oriented. Here at the Agency for Healthcare Research and Quality (AHRQ), we're supporting and encouraging organizations to work with facilitators who are trained to take a team approach to change. Through our online Patient-Centered Medical Home Resource Center (http://www.pcmh.ahrq.gov), we offer resources, webinars, newsletters, and a guidebook some of my colleagues here at AHRQ only half jokingly refer to as a bestseller Developing and Running a Primary Care Facilitation Program: A How-To Guide.
One of the reasons practice facilitators are so successful helping practices change is that they share their expertise, statistics, and stories about what they've seen working in other practices. Some of these facilitators' stories are in the cover story of this issue of Research Activities. My crystal ball tells me that practice facilitators provide one way to improve primary care. What do you see?
Carolyn Clancy, MD
The article on the impact of diabetes on school dropout rates and wages on page 6 of the November issue of Research Activities failed to note that Type 1 diabetes is not considered preventable, and that the authors' calls for prevention measures apply to those with type 2 diabetes, which may be prevented by changes in diet, exercise, and other lifestyle factors. You can see the corrected article at www.ahrq.gov/research/nov12/1112RA5.htm.