The patient-centered medical home was introduced with the Affordable Care Act to focus on primary care with a high degree of patient involvement and collaboration to treat a variety of health concerns effectively and efficiently within the parameters of the practice setting (Edwards, Bitton, Hong, & Landon, 2014). This legislation affects members of all population groups who receive primary care and who strive to become better involved in their care; furthermore, it is intended to provide oversight in the primary care setting to ensure that patients receive the best possible approaches to care and treatment which impact decision-making and long-term care (Edwards et.al, 2014).
All 50 states have established some degree of legislation regarding patient-centered medical homes and this practice is governed by state legislatures, such as the State of Ohio, which continues to expand this practice through the Ohio Department of Health and the 128th Ohio General Assembly under HB 198 (Patient-Centered Primary Care Collaborative, 2015).
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The patient-centered medical home provides an opportunity to explore the different dimensions of patient care which influence change and progress for patients; however, this poses a challenge to teams who work with patients and the coordination of care across multidisciplinary teams (O’Malley, Gourevitch, Draper, Bond, & Tirodkar, 2015). Therefore, teams must identify individual tasks and support a communicative and collaborative environment to meet patient care needs and expectations (O’Malley et.al, 2015). Advanced practice nurses must play a critical role in the patient-centered medical home because they offer opportunities for growth that impact change and innovation at the practice level (Auerbach, Chen, Friedberg, Lau, Buerhaus, & Mehrotra, 2013). In addition, this legislation is important in utilizing a variety of specialty areas and in supporting a dynamic which will positively impact change within the healthcare setting (Auerbach et.al, 2013).
The patient-centered medical home is designed to facilitate collaboration and the need for multidisciplinary care at the practice level, and this model has been created to address some of the critical gaps in current models which could have a negative impact on patients (Jackson et.al, 2013). Nurses and other healthcare providers must work collaboratively and introduce new ideas to ensure that patients receive the best possible care and treatment and that these strategies are comprehensive and approach plans of care (Jackson et.al, 2013). To achieve the desired goals and objectives, patient care must be organized effectively and efficient so that patients are treated with the best possible approaches that are available (Jackson et.al, 2013). These factors support a dynamic in which patient care is supported by different needs and expectations, along with understanding the demands of care and treatment (Jackson et.al, 2013). Nurses must contribute to the patient-centered medical home to meet expectations and to consider the impact of these efforts on improving quality of care and patient safety (Jackson et.al, 2013).
The patient-centered medical home has emerged as common practice in meeting the needs and expectations of the practice environment and in seeking opportunities to improve quality of care for patients in a variety of settings. There must be a greater emphasis on exploring the dimensions of patient care which enable advanced practice nurses to achieve greater involvement in these activities to ensure that patients receive optimal and comprehensive care from a multidisciplinary team. This legislation is critical in advancing primary care objectives and in supporting widespread involvement from a variety of areas to meet the expectations of the practice environment.
