Milestones and Entrustable Professional Activities: The Key to Practically Translating Competencies for Interprofessional Education?
Competency-based education and practice have become foundational for developing interprofessional education (IPE) and interprofessional collaboration. There has been a plethora of competencies developed in these areas recently, both at individual institutions and nationally; however, their effective integration and thus potential has not been fully realized educationally.
The 10 building blocks of high-performing primary care
Our experiences studying exemplar primary care practices, and our work assisting other practices to become more patient centered, led to a formulation of the essential elements of primary care, which we call the 10 building blocks of high-performing primary care.
Team structure and culture are associated with lower burnout in primary care.
PURPOSE:
Burnout is a threat to the primary care workforce. We investigated the relationship between team structure, team culture, and emotional exhaustion of clinicians and staff in primary care practices.
METHODS:
Overcoming challenges to teamwork in patient-centered medical homes: a qualitative study
BACKGROUND:
There is emerging consensus that enhanced inter-professional teamwork is necessary for the effective and efficient delivery of primary care, but there is less practical information specific to primary care available to guide practices on how to better work as teams.
OBJECTIVE:
The purpose of this study was to describe how primary care practices have overcome challenges to providing team-based primary care and the implications for care delivery and policy.
APPROACH:
In search of joy in practice: a report of 23 high-functioning primary care practices.
We highlight primary care innovations gathered from high-functioning primary care practices, innovations we believe can facilitate joy in practice and mitigate physician burnout. To do so, we made site visits to 23 high-performing primary care practices and focused on how these practices distribute functions among the team, use technology to their advantage, improve outcomes with data, and make the job of primary care feasible and enjoyable as a life's vocation.
From triple to quadruple aim: care of the patient requires care of the provider.
The Triple Aim-enhancing patient experience, improving population health, and reducing costs-is widely accepted as a compass to optimize health system performance. Yet physicians and other members of the health care workforce report widespread burnout and dissatisfaction. Burnout is associated with lower patient satisfaction, reduced health outcomes, and it may increase costs. Burnout thus imperils the Triple Aim.
Elements of team-based care in a patient-centered medical home are associated with lower burnout among VA primary care employees.
BACKGROUND:
A high proportion of the US primary care workforce reports burnout, which is associated with negative consequences for clinicians and patients. Many protective factors from burnout are characteristics of patient-centered medical home (PCMH) models, though even positive organizational transformation is often stressful. The existing literature on the effects of PCMH on burnout is limited, with most findings based on small-scale demonstration projects with data collected only among physicians, and the results are mixed.
A Cluster Randomized Trial of Interventions to Improve Work Conditions and Clinician Burnout in Primary Care: Results from the Healthy Work Place (HWP) Study.
BACKGROUND:
Work conditions in primary care are associated with physician burnout and lower quality of care.
OBJECTIVE:
We aimed to assess if improvements in work conditions improve clinician stress and burnout.
SUBJECTS:
Primary care clinicians at 34 clinics in the upper Midwest and New York City participated in the study.
STUDY DESIGN:
This was a cluster randomized controlled trial.
MEASURES:
Transforming the delivery of care in the post-health reform era: what role will community health workers play?
The Patient Protection and Affordable Care Act (PPACA) affords opportunities to sustain the role of community health workers (CHWs). Among myriad strategies encouraged by PPACA are prevention and care coordination, particularly for chronic diseases, chief drivers of increased health care costs. Prevention and care coordination are functions that have been performed by CHWs for decades, particularly among underserved populations. The two key delivery models promoted in the PPACA are accountable care organizations and health homes.
The Silent Treatment: Why Safety Tools and Checklists Aren’t Enough to Save Lives
Silence Kills was conducted immediately before AACN’s national standards for healthy work environments were released. It identified seven concerns that often go undiscussed and contribute to avoidable medical errors. It linked the ability of health professionals to discuss emotionally and politically risky topics in a healthcare setting to key results like patient safety, quality of care, and nursing turnover, among others.