A medical home: changing the way patients and teams relate through patient-centered care plans.

The patient-centered medical home model incorporates patient-centered care as a central tenet and espouses the health care team partnering with an engaged patient. The tools to accomplish this type of care have not evolved along with these values. This report describes how the adoption and use of a patient-centered care plan (PCCP) document enhanced care for complex patients and changed the relationships with health team members. The PCCP was used in a residency-affiliated community hospital, group family medicine site and provided patient-centered, goal-directed care for complex patients. Use of the PCCP changed the patient-team relationship, showing that this care plan document can support the practice of the patient-centered medical home model by enhancing patient-centered, coordinated, comprehensive care. (PsycINFO Database Record (c) 2012 APA, all rights reserved).