Models of Complex Care Management: LEAP Webinar Series #2

Multiple chronic illnesses, combined with co-existing mental/behavioral health problems, along with frailty and functional limitations pose great challenges to the work of the busy primary care team.  The “Models of Complex Care Management” webinar was recorded in January 2014 and features the work of LEAP sites in Maine, Louisiana, Texas and West Virginia. This conversation asks how to build a system that supports the care of this population? How do we identify these patients?

Changing the Culture of Care in Your Community: LEAP Webinar Series #1

First in a series of six webinars recorded for our PCT-LEAP initiative, “Changing the Culture of Care in Your Community” showcases LEAP sites that are change agents in their communities even beyond their patient population, as well as doing the work of addressing the social determinants of health in a number of venues.   We discuss the health care provider and team role in population health, and ask the question:  how do you build and sustain community partnerships that transform both health care prac

LEAP Getting Started video

Short video describing the PCT-LEAP project, featuring RWJF Senior Program Officer Maryjoan Ladden, PhD, RN, FAAN and LEAP Co-Director Margaret Flinter, PhD, APRN.  In MaryJoan Ladden's words, the LEAP Guide is "the nitty-gritty of how do you do it (deliver better primary care), getting it out there in a way that people can really practically use it."

 

The Practice Perspective on Transformation: Experience and Learning from the Frontlines

This brief report offers impressions from leaders in two primary care practices that participated in the Safety Net Medical Home Initiative, contextualizing the experience of practice transformation from the perspective of the medical practice and providing insight on approaches that may support success.  One of the papers included in the November 2014 Medical Care Supplement about the SNMHI.

Associations Between Medical Home Characteristics and Support for Patient Activation in the Safety Net: Understanding Differences by Race, Ethnicity, and Health Status

This paper assesss the association between SNMHI clinic PCMH characteristics and patient perception of clinic support for patient activation, and whether that association varies by patients' self-reported race/ethnicity or health status.  One of the papers about our Safety Net Medical Home Initiative included in the November 2014 Med