Ten Common Structures and Processes of High-Performing Primary Care Practices

Ann M. Nguyen, Margaret M. Paul, Donna R. Shelley, Stephanie L. Albert, Deborah J. Cohen, Pam Bonsu, Tamar Wyte-Lake, Saul Blecker, Carolyn A. Berry

Research output: Contribution to journalArticlepeer-review


Structures (context of care delivery) and processes (actions aimed at delivery care) are posited to drive patient outcomes. Despite decades of primary care research, there remains a lack of evidence connecting specific structures/processes to patient outcomes to determine which of the numerous recommended structures/processes to prioritize for implementation. The objective of this study was to identify structures/processes most commonly present in high-performing primary care practices for chronic care management and prevention. We conducted key informant interviews with a national sample of 22 high-performing primary care practices. We identified the 10 most commonly present structures/processes in these practices, which largely enable 2 core functions: mobilizing staff to conduct patient outreach and helping practices avoid gaps in care. Given the costs of implementing and maintaining numerous structures/processes, our study provides a starting list for providers to prioritize and for researchers to investigate further for specific effects on patient outcomes.

Original languageEnglish (US)
Pages (from-to)E639-E644
JournalJournal of Public Health Management and Practice
Issue number2
StatePublished - Mar 1 2022


  • Health services
  • Practice-based research
  • Primary care

ASJC Scopus subject areas

  • Health Policy
  • Public Health, Environmental and Occupational Health


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