Background Serious shortcomings remain in clinical care in the United States despite
widespread use of improvement strategies for enhancing clinical performance based on …

This article examines the past, present and future of primary care and teamwork. It begins
with a definition and description of primary care–its uniqueness, diversity and complexity …

Many wonder why there has been so little change in care quality despite substantial quality
improvement efforts. Questioning why current approaches are not making true changes …

Background: Change champions are important for moving new innovations through the
phases of initiation, development, and implementation. Although research attributes positive …

Grounded theory and action research are not usually regarded as similar approaches to
research. Indeed, there are important differences. However, both develop theory grounded …

PURPOSE Numerous primary care practice development efforts, many related to the patient-
centered medical home (PCMH), are emerging across the United States with few guides …

PURPOSE On the eve of major primary health care reforms, we conducted a multilevel
survey of primary health care clinics to identify attributes of clinic organization and physician …

Background Those attempting to implement changes in health care settings often find that
intervention efforts do not progress as expected. Unexpected outcomes are often attributed …

Article-at-a-Glance Background Understanding the role of relationships in health care
organizations (HCOs) offers opportunities for shaping health care delivery. When quality is …

Much variation exists in family practices. There is also much that is constant and deeply
resistant to change. In this paper we present the current state of an ongoing 4-year process …