| The life expectancy of Americans is increasing along with the number of individuals with one or more chronic conditions. However, it has been rigorously documented from public and private sources that care for those with chronic illnesses, including preventive services, falls short of recommended evidence-based guidelines. To address this problem, it is critical to explore how to diffuse models of care that better meet patients' needs and engage them actively in their self-care---as research has shown such approaches produce better health outcomes. This research study sought to identify success factors and barriers among organizations participating in the Alliance of Community Health Plans' Advancing Better Care (ABC) collaborative that were implementing quality improvement interventions designed to increase levels of "patient activation". Specifically, research questions explored were: (1) What are the most important variables---positive and negative---impacting implementation of the patient activation projects in the ABC collaborative? (a) What are the key success factors for implementing this intervention? (b) What barriers to implementation are consistent amongst the participating organizations? (2) How is patient activation currently being conceptualized? (3) What metrics are being used to measure patient activation?;Qualitative methods were used to conduct this research including one-on-one interviews, a focus group, and a feedback session to study informants. Success factors identified in order of frequency included: positive marketing of the intervention; alignment of the intervention with strategic goals of the organization; senior leadership support of the intervention; organizational culture that was patient-centered; and getting buy-in from stakeholder groups both internal and external to the organization.;Barriers included: technical limitations of existing databases; communicating data to consumers in an understandable manner; concerns over confidentiality; obtaining stakeholder buy-in; change management; the range of activation among patients; and the difficulty linking interventions to outcomes to demonstrate a return on investment. A key finding of the study was that measuring patient activation (outcome) as part of routine practice presents many logistical challenges and presently members of the ABC collaborative are focusing on intermediate types of measures (structure, process) that relate more directly to the sustainability of the project. |
