1. Primary Care 2.0: A Prospective Evaluation of a Novel Model of Advanced Team Care With Expanded Medical Assistant Support
- Author
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Shaw, Jonathan G, Winget, Marcy, Brown-Johnson, Cati, Seay-Morrison, Timothy, Garvert, Donn W, Levine, Marcie, Safaeinili, Nadia, and Mahoney, Megan R
- Subjects
Health Services and Systems ,Biomedical and Clinical Sciences ,Health Sciences ,Clinical Research ,Health Services ,Good Health and Well Being ,Burnout ,Professional ,Humans ,Patient Care Team ,Patient Satisfaction ,Physicians ,Primary Care ,Primary Health Care ,Surveys and Questionnaires ,burnout ,healthcare team ,healthcare workforce ,organizational innovation ,primary care team ,Medical and Health Sciences ,Studies in Human Society ,General & Internal Medicine ,Biomedical and clinical sciences ,Health sciences ,Human society - Abstract
PurposeAssess effectiveness of Primary Care 2.0: a team-based model that incorporates increased medical assistant (MA) to primary care physician (PCP) ratio, integration of advanced practice clinicians, expanded MA roles, and extended the interprofessional team.MethodsProspective, quasi-experimental evaluation of staff/clinician team development and wellness survey data, comparing Primary Care 2.0 to conventional clinics within our academic health care system. We surveyed before the model launch and every 6-9 months up to 24 months post implementation. Secondary outcomes (cost, quality metrics, patient satisfaction) were assessed via routinely collected operational data.ResultsTeam development significantly increased in the Primary Care 2.0 clinic, sustained across all 3 post implementation time points (+12.2, +8.5, + 10.1 respectively, vs baseline, on the 100-point Team Development Measure) relative to the comparison clinics. Among wellness domains, only "control of work" approached significant gains (+0.5 on a 5-point Likert scale, P = .05), but was not sustained. Burnout did not have statistically significant relative changes; the Primary Care 2.0 site showed a temporal trend of improvement at 9 and 15 months. Reversal of this trend at 2 years corresponded to contextual changes, specifically, reduced MA to PCP staffing ratio. Adjusted models confirmed an inverse relationship between team development and burnout (P
- Published
- 2021