Taking Efficiency Interventions in Health Services Delivery to Scale

Dates: 2013-2016

State: Maine

Client(s): Agency for Healthcare Research and Quality (AHRQ)

Service: Applied Research & Evaluation

Technical Expertise: Primary Care, Safety Net

Primary care in the United States is under pressure for rapid transformation to simultaneously address the shortage in providers and at the same time offer an enhanced model of patient centered and holistic care. JSI is working work with Penobscot Community Health Care (PCHC), a Federally Qualified Health Center located in Bangor, Maine, to evaluate its efforts in spreading a “delegate model” to five of its service sites.

The intended impact of the delegate model is collaborative care that will increase the efficiency of the care team and improve access.

The delegate model incorporates an interdisciplinary care team approach, with careful examination and redistribution of the roles of each team member to improve efficiency as measured through panel size, wait times to third available appointment, and cycle times. The evaluation will draw on Pawson and Tilley’s realistic evaluation framework and the Consolidated Framework for Implementation Research (CFIR) and assess the contextual factors that facilitate or inhibit the spread of the delegation model.


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