Orchestrating Large Organizational Change in Primary Care: The Veterans' Health Administration Experience Implementing a Patient-Centered Medical Home.

The article discusses the Patient Aligned Care Team initiative launched by the U.S. Veterans Health Administration (VHA). It is noted that the model would require providers enhanced skills in order to collaborate with patients to help manage their care and share in decisions. These skills include cultural competency, motivational interviewing and proficiency in managing disagreements. The steps in organizing change in primary care are detailed.