{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T07:58:55Z","timestamp":1790841535899,"version":"4.1.0"},"reference-count":30,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T00:00:00Z","timestamp":1789084800000},"content-version":"vor","delay-in-days":72,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pulm. circ."],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Pulmonary hypertension (PH) is a progressive disease associated with high morbidity and mortality. Despite advancements, gaps in PH care quality persist, though the drivers of these gaps are incompletely understood. Thus, we sought to explore patient and provider perspectives on high\u2010quality PH care. We conducted a multi\u2010site qualitative study at three expert PH centers in the United States, involving telephone interviews with 20 providers and 22 patients. We conducted a reflexive thematic analysis, using the Institute of Medicine's (IOM) six domains of healthcare quality (safe, effective, patient\u2010centered, timely, efficient, and equitable) as an a priori coding scheme, with subcodes developed under each domain. We then compared codes across IOM domains and patient and provider data to identify overarching themes. Our analysis revealed three cross\u2010cutting themes that encompassed all six IOM healthcare quality domains, covered all identified subcodes, and represented both provider and patient perspectives: (1) \u201cIt takes a village,\u201d that is, the expansive team needed to provide care for a patient with PH; (2) The need for care coordination within a PH center, with specialty pharmacies, and with community providers; and (3) PH centers as a model to deliver high\u2010quality care. Finally, participants offered clear recommendations for addressing gaps in care quality, including expanding village members, such as the addition of social workers, improving care coordination by improving patient follow\u2010up and tracking, and expanding access to PH centers by having a PH center presence in the community. These findings highlight key areas for targeted improvements in PH care quality.<\/jats:p>","DOI":"10.1002\/pul2.70408","type":"journal-article","created":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T16:59:07Z","timestamp":1789145947000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Quality of Pulmonary Hypertension Care Within Expert PH Centers: Patient and Provider Perspectives From a Multi\u2010Site Qualitative Study"],"prefix":"10.1002","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-9446-937X","authenticated-orcid":false,"given":"Michelle M.","family":"Hall","sequence":"first","affiliation":[{"name":"The Pulmonary Center Boston University Chobanian &amp; Avedisian School of Medicine Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8662-1224","authenticated-orcid":false,"given":"Seppo T.","family":"Rinne","sequence":"additional","affiliation":[{"name":"Center for Health Optimization &amp; Implementation Research VA Boston Healthcare System, Boston, MA and VA Bedford Healthcare System Bedford MA USA"},{"name":"Geisel School of Medicine at Dartmouth Lebanon NH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7088-3118","authenticated-orcid":false,"given":"A. Rani","family":"Elwy","sequence":"additional","affiliation":[{"name":"Center for Health Optimization &amp; Implementation Research VA Boston Healthcare System, Boston, MA and VA Bedford Healthcare System Bedford MA USA"},{"name":"Warren Alpert Medical School of Brown University Providence RI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7712-2135","authenticated-orcid":false,"given":"Renda Soylemez","family":"Wiener","sequence":"additional","affiliation":[{"name":"The Pulmonary Center Boston University Chobanian &amp; Avedisian School of Medicine Boston MA USA"},{"name":"Center for Health Optimization &amp; Implementation Research VA Boston Healthcare System, Boston, MA and VA Bedford Healthcare System Bedford MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5333-259X","authenticated-orcid":false,"given":"Kari R.","family":"Gillmeyer","sequence":"additional","affiliation":[{"name":"The Pulmonary Center Boston University Chobanian &amp; Avedisian School of Medicine Boston MA USA"},{"name":"Center for Health Optimization &amp; Implementation Research VA Boston Healthcare System, Boston, MA and VA Bedford Healthcare System Bedford MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,11]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehac237"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-2600(23)00264-3"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.122.026413"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/pul2.12171"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1086\/686489"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1513\/AnnalsATS.201710-762OC"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.11-3060"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/pul2.12188"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.2830"},{"key":"e_1_2_12_11_1","volume-title":"Crossing the Quality Chasm: A New Health System for the 21st Century","author":"Institute of Medicine (US), Committee on Quality of Health Care in America","year":"2001"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/s1549-3741(04)30040-7"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10488-013-0528-y"},{"key":"e_1_2_12_14_1","volume-title":"Enlisting the Gatekeeper: Chain\u2010Referral and Elite Access in Foreign Policy Analysis","author":"Mendez A.","year":"2020"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-981-10-5251-4_103"},{"key":"e_1_2_12_16_1","volume-title":"PH Care Centers\u2014Accredited Centers","author":"PHA","year":"2024"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11096-020-01047-8"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2023.24035"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2022.765461"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.23.00293"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000947"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000001141"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-021-07140-6"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2010.01.006"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jchf.2019.09.008"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0000000000000245"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2020.01.046"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.1513\/AnnalsATS.202408-901OC"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.202404-0816OC"},{"key":"e_1_2_12_30_1","doi-asserted-by":"publisher","DOI":"10.1513\/AnnalsATS.202205-404OC"},{"key":"e_1_2_12_31_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12890-025-03817-4"}],"container-title":["Pulmonary Circulation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pul2.70408","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/pul2.70408","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pul2.70408","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T07:20:34Z","timestamp":1790839234000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/pul2.70408"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7]]},"references-count":30,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,7]]}},"alternative-id":["10.1002\/pul2.70408"],"URL":"https:\/\/doi.org\/10.1002\/pul2.70408","archive":["Portico"],"relation":{},"ISSN":["2045-8940","2045-8940"],"issn-type":[{"value":"2045-8940","type":"print"},{"value":"2045-8940","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7]]},"assertion":[{"value":"2026-03-24","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-01","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-11","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70408"}}