Chapter 8. Health System Infrastructure

Ensuring well-coordinated, high-quality health care requires the establishment of a supportive health system infrastructure. High-performance health systems require a well-distributed workforce, information systems for data collection, quality improvement analysis, and clinical communication support, as well as the organizational capacity to support culturally competent services and ongoing improvement efforts.1 Health care models such as Wagner’s Chronic Care Model (CCM) and Patient-Centered Medical Home (PCMH) promote a safety culture for patients. CCM promotes health care delivery systems designed to support community-based resources, self-management of care, and information support systems. Information support systems provide the basis for much of the continuity in patient records and clinician communication. PCMH uses a team-based model led by a primary care physician who provides continuous and coordinated care throughout the patient’s life. Features such as open scheduling, expanded hours, and new options for communication between patients and their personal physicians and practice staff enhance patient experiences and improve the quality of care. A well-integrated, culturally competent health care delivery system that allows patient information to be readily available to providers positively affects the quality and efficiency of care and therefore patient outcomes. The adoption and use of health information technology (IT) can be an effective way to manag