The practice perspective on transformation: experience and learning from the frontlines.

BACKGROUND: The transition of a primary care practice to a patient-centered medical home can be arduous. It requires time and resources from staff and leaders. Evidence to date suggests that not all medical homes are equally successful and that there is a substantial difference between the achievement of medical home recognition and meaningful transformation. However, little information is available to help a practice understand which approaches or strategies it might employ to prepare itself for successful transformation.
OBJECTIVES: Leaders in 2 very different primary care practices that participated in the Safety Net Medical Home Initiative (SNMHI) offer their impressions, contextualizing the experience of practice transformation from the perspective of the medical practice and providing insight on approaches that may support success.
DESIGN: The authors self-identified a set of shared approaches they believe allowed their organizations to successfully implement and sustain changes consistent with the PCMH Model of Care.
RESULTS: The approaches are: (1) harness the power of meaning; (2) approach PCMH implementation as a large-scale cultural transformation; (3) engage frontline staff and patients in the change process; (4) develop leadership's capacity to manage and support the change process; (5) consider sustainability from the beginning.