Implementation of Women's Health Patient Aligned Care Teams

Completed · Not applicable

Conditions studied: Patient-centered Medical Home Implementation

In brief

VA has undertaken a major initiative to transform care through implementation of Patient Aligned Care Teams (PACTs). Based on the patient-centered medical home (PCMH) concept, PACT aims to improve access, continuity, coordination and comprehensiveness using team-based care that is patient-driven and patient-centered. However, how VA should adapt PACT to meet the needs of special populations, such as women Veterans, is yet to be worked out. The main goal of this study was to develop and test an evidence-based quality improvement (EBQI) approach to adapting and implementing PACT for women Veterans, incorporating comprehensive women's health care in gender-sensitive care environments, thereby accelerating achievement of PACT tenets for women Veterans and reducing persistent gender disparities in VA quality of care.

Key facts

Study ID

NCT02039856

Run by

VA Office of Research and Development

People needed

3900

Starts

2014-05-09

Expected to finish

2018-09-30

Last updated by the study team

2023-06-18

Who can join

Age: 18 and older. Sex: any. Healthy volunteers: not accepted.

You may qualify if…

• Facility inclusion criteria:
• VA medical center (VAMC)
• Located in a VISN that has 3 or more VAMCs
• Membership in the Women's Health Practice Based Research Network (PBRN)
• Key Stakeholder (interviews) inclusion criteria:
• VISN and VAMC leaders, VAMC primary care/PACT directors, VAMC women's health medical directors, Women Veteran Program Managers (VISN and VAMC), VISN representatives in mental health, health information technology/informatics, quality improvement/system redesign, at least one Nurse Executive (VISN or VAMC)
• Intervention and control VAMCs
• Provider (surveys and interviews) inclusion criteria:
• Primary care providers (medical doctor [MD], doctor of osteopathy [DO], nurse practitioner [NP], physician assistant [PA]) who have seen 1+ women Veterans in the past year
• Teamlet primary care provider interviews (MD, DO, NP, PA) at intervention VAMCs
• Surveys of primary care providers (MD, DO, NP, PA) at intervention and control VAMCs
• Surveys of larger primary care/PACT team members (e.g., clinical pharmacists, health coaches)
• Staff (surveys and interviews) inclusion criteria:
• Primary care/PACT clinical staff (non-providers) in primary care/PACT teams/teamlets that have seen 1+ women Veterans in the past year
• Teamlet member interviews at Intervention VAMCs
• Patient inclusion criteria:
• Women Veterans seen in participating VAMCs with 3+ primary care visits in general primary care and/or women's health clinics in the past year

You may not qualify if…

• Facility exclusion criteria:
• VA facilities that are not VAMCs (e.g., community-based outpatient clinics or CBOCs)
• VAMCs in VISNs with fewer than 3 VAMCs
• VAMCs that are not members of the WH PBRN
• Key Stakeholder (interviews) exclusion criteria:
• Stakeholders outside of the participating VISNs (1, 4, 12, 23) and VAMCs (see study sites)
• Provider (surveys and interviews) exclusion criteria:
• VA providers who do not deliver primary care in participating VAMCs
• VA primary care providers who have not seen or do not see women Veteran patients for primary care delivery at a participating VAMC
• Teamlet providers at control VAMCs will not be interviewed
• Staff (surveys and interviews) exclusion criteria:
• Primary care clinical staff not participating in PACT (e.g., assigned to primary care rolls but not actually associated with primary care/PACT direct patient care delivery)
• Primary care/PACT clinical staff at control VAMCs will not be interviewed
• Patient exclusion criteria:
• Women Veterans who do not use the VA for their health care or for their primary care needs
• Women Veterans with fewer than 3 VA primary care visits in the prior year and therefore not exposed to PACT or WH PACT
• Women Veterans with terminal illness and/or poor prognosis or other health concerns for whom enrollment and survey participation would prove an inappropriate burden

Where it is running

• VA Greater Los Angeles Healthcare System, Sepulveda, CA — Sepulveda, California, United States
• VA Connecticut Healthcare System West Haven Campus, West Haven, CT — West Haven, Connecticut, United States
• Jesse Brown VA Medical Center, Chicago, IL — Chicago, Illinois, United States
• Edward Hines Jr. VA Hospital, Hines, IL — Hines, Illinois, United States
• Iowa City VA Health Care System, Iowa City, IA — Iowa City, Iowa, United States
• VA Boston Healthcare System Jamaica Plain Campus, Jamaica Plain, MA — Boston, Massachusetts, United States
• VA Central Western Massachusetts Healthcare System, Leeds, MA — Leeds, Massachusetts, United States
• Minneapolis VA Health Care System, Minneapolis, MN — Minneapolis, Minnesota, United States
• Fargo VA Healthcare System, Fargo, ND — Fargo, North Dakota, United States
• Philadelphia VA Medical Center, Philadelphia, PA — Philadelphia, Pennsylvania, United States
• VA Pittsburgh Healthcare System University Drive Division, Pittsburgh, PA — Pittsburgh, Pennsylvania, United States
• Clarksburg Louis A. Johnson VA Medical Center, Clarksburg, WV — Clarksburg, West Virginia, United States
• William S. Middleton Memorial Veterans Hospital, Madison, WI — Madison, Wisconsin, United States

Full record on ClinicalTrials.gov

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