Observational studyJournal of general internal medicine2014
Getting performance metrics right: a qualitative study of staff experiences implementing and measuring practice transformation.
Observational study in Journal of general internal medicine, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
19 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Pay-for-Performance and Veteran Care in the VHA and the Community: a Systematic Review.Journal of general internal medicine · 2018Pooled it
- "Kind of Feel Like the Lone Outpost": A Qualitative Exploration of Barriers to Professional Development for Rural Primary Care Providers at the Veterans Health Administration.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2026Article
- Patient-Centered Prioritization of Health Care Processes for Multimorbidity.JAMA network open · 2025Article
- Medical Home Implementation and Follow-Up of Cancer-Related Abnormal Test Results in the Veterans Health Administration.JAMA network open · 2024Article
- Culture of Safety Quality Improvement Project: Longitudinal AHRQ Survey Results From a Family Medicine Residency Program.PRiMER (Leawood, Kan.) · 2023Article
- Incentivizing performance in health care: a rapid review, typology and qualitative study of unintended consequences.BMC health services research · 2022Review
- Association of Primary Care Physician Compensation Incentives and Quality of Care in the United States, 2012-2016.Journal of general internal medicine · 2022Article
- How can technology support quality improvement? Lessons learned from the adoption of an analytics tool for advanced performance measurement in a hospital unit.BMC health services research · 2020Article
- Measurement without management: qualitative evaluation of a voluntary audit & feedback intervention for primary care teams.BMC health services research · 2019Article
- Primary care clinicians' perspectives about quality measurements in safety-net clinics and non-safety-net clinics.International journal for equity in health · 2018Article
- A qualitative study of implementation and adaptations to Progressive Tinnitus Management (PTM) delivery.PloS one · 2018Article
- Perceptions of Risk Stratification Workflows in Primary Care.Healthcare (Basel, Switzerland) · 2017Article
- Barriers and facilitators to providing primary care-based weight management services in a patient centered medical home for Veterans: a qualitative study.BMC family practice · 2015Article
- Informatics Systems and Tools to Facilitate Patient-centered Care Coordination.Yearbook of medical informatics · 2015Review
- Factors Underlying Quality Problems with Alcohol Screening Prompted by a Clinical Reminder in Primary Care: A Multi-site Qualitative Study.Journal of general internal medicine · 2015Observational
- Association Between Receipt of Brief Alcohol Intervention and Quality of Care among Veteran Outpatients with Unhealthy Alcohol Use.Journal of general internal medicine · 2015Article
- Effects of performance measure implementation on clinical manager and provider motivation.Journal of general internal medicine · 2014Article
- Article
- "Salt in the Wound": Safety Net Clinician Perspectives on Performance Feedback Derived From EHR Data.The Journal of ambulatory care managementArticle
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundQuality improvement is a central goal of the patient-centered medical home (PCMH) model, and requires the use of relevant performance measures that can effectively guide comprehensive care improvements. Existing literature suggests performance measurement can lead to improvements in care quality, but may also promote practices that are detrimental to patient care. Staff perceptions of performance metric implementation have not been well-researched in medical home settings.
objectiveTo describe primary care staff (clinicians and other staff) experiences with the use of performance metrics during the implementation of the Veterans Health Administration's (VHA) Patient Aligned Care Team (PACT) model of care.
designObservational qualitative study; data collection using role-stratified focus groups and semi-structured interviews.
participantsTwo hundred and forty-one of 337 (72 %) identified primary care clinic staff in PACT team and clinic administrative/other roles, from 15 VHA clinics in Oregon and Washington. APPROACH: Data coded and analyzed using conventional content analysis techniques. KEY
resultsPrimary care staff perceived that performance metrics: 1) led to delivery changes that were not always aligned with PACT principles, 2) did not accurately reflect patient-priorities, 3) represented an opportunity cost, 4) were imposed with little communication or transparency, and 5) were not well-adapted to team-based care.
conclusionsPrimary care staff perceived responding to performance metrics as time-consuming and not consistently aligned with PACT principles of care. The gaps between the theory and reality of performance metric implementation highlighted by PACT team members are important to consider as the medical home model is more widely implemented.
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