Primary Care Practices' Implementation of Patient-Team Partnership: Findings from EvidenceNOW Southwest

J Am Board Fam Med. 2019 Jul-Aug;32(4):490-504. doi: 10.3122/jabfm.2019.04.180361.


Introduction: Care teams partnering with patients are integral to quality primary care. Effective patient-team partnership recognizes patients' contributions in decision-making and respecting patients' goals and social context. We report practice characteristics associated with greater patient-team partnership scores.

Methods: EvidenceNOW Southwest was a multistate initiative to improve cardiovascular care in primary care practices through guideline-concordant aspirin use, blood pressure control, cholesterol management, and smoking cessation. EvidenceNOW Southwest provided 9 months of practice facilitation and information technology support through regular meetings and training to 211 Colorado and New Mexico primary care practices from 2015 to 2017. We analyzed surveys from 97% of participating practices regarding patient-team partnership activities of self-management support, social need assessment, resource linkages, and patient input. We used linear and mixed effects regression modeling to examine relationships between patient-team partnership and practice characteristics.

Results: Practice characteristics significantly associated with greater patient-team partnership were using patient registries, medically underserved area designation, multispecialty mix, and using clinical cardiovascular disease management guidelines. Our findings suggest that patient-team partnership implementation in small primary care practices is moderate, with mean practice- and member-level scores of 52 of 100 (range, 0-100) and 71 of 100 (range, 10-100), respectively.

Conclusion: Practices can improve efforts to partner with patients to assess social needs, gather meaningful input on practice improvement and patient experience, and offer resource connections. Our findings supplement recent evidence that patient registries and evidence-based guidelines may effectively prevent and manage cardiovascular disease. These strategies may also promote primary care patient-team partnership.

Keywords: Colorado; Cross-Sectional Studies; New Mexico; Partnership Practice; Patient Care Team; Patient-Centered Care; Primary Health Care; Quality Improvement; Registries; Surveys and Questionnaires.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Cardiovascular Diseases / therapy*
  • Colorado
  • Cross-Sectional Studies
  • Decision Making, Shared*
  • Guideline Adherence / organization & administration
  • Guideline Adherence / statistics & numerical data
  • Health Plan Implementation / organization & administration
  • Health Plan Implementation / statistics & numerical data
  • Health Services Research / statistics & numerical data
  • Humans
  • Medically Underserved Area
  • New Mexico
  • Patient Care Team / organization & administration*
  • Patient Participation*
  • Practice Guidelines as Topic
  • Primary Health Care / organization & administration*
  • Primary Health Care / standards
  • Primary Health Care / statistics & numerical data
  • Quality Improvement
  • Registries / statistics & numerical data
  • Self-Management
  • Surveys and Questionnaires / statistics & numerical data