Chapman Susan A, Blash Lisel K
Department of Social and Behavioral Sciences, UCSF School of Nursing, Healthforce Center, Philip R. Lee Institute for Health Policy Studies, San Francisco, CA.
UCSF Healthforce Center and Philip R. Lee Institute for Health Policy Studies, San Francisco, CA.
Health Serv Res. 2017 Feb;52 Suppl 1(Suppl 1):383-406. doi: 10.1111/1475-6773.12602. Epub 2016 Nov 10.
To identify and describe new roles for medical assistants (MAs) in innovative care models that improve care while providing training and career advancement opportunities for MAs.
DATA SOURCES/STUDY SETTING: Primary data collected at 15 case study sites; 173 key informant interviews and de-identified secondary data on staffing, wages, patient satisfaction, and health outcomes.
Researchers used snowball sampling and screening calls to identify 15 organizations using MAs in new roles. Conducted site visits from 2010 to 2012 and updated information in 2014.
DATA COLLECTION/EXTRACTION METHODS: Thematic analysis explored key topics: factors driving MA role innovation, role description, training required, and wage gains. Categorized outcome data in patient and staff satisfaction, quality of care, and efficiency.
New MA roles included health coach, medical scribe, dual role translator, health navigator, panel manager, cross-trained flexible role, and supervisor. Implementation of new roles required extensive training. MA incentives and enhanced compensation varied by role type.
New MA roles are part of a larger attempt to reform workflow and relieve primary care providers. Despite some evidence of success, spread has been limited. Key challenges to adoption included leadership and provider resistance to change, cost of additional MA training, and lack of reimbursement for nonbillable services.
确定并描述医疗助理(MAs)在创新护理模式中的新角色,这些模式在改善护理的同时为医疗助理提供培训和职业发展机会。
数据来源/研究背景:在15个案例研究地点收集的原始数据;173次关键 informant 访谈以及关于人员配备、工资、患者满意度和健康结果的去识别化二手数据。
研究人员使用滚雪球抽样和筛选电话来识别15个在新角色中使用医疗助理的组织。在2010年至2012年进行实地考察,并在2014年更新信息。
数据收集/提取方法:主题分析探讨了关键主题:推动医疗助理角色创新的因素、角色描述、所需培训和工资增长。对患者和员工满意度、护理质量和效率方面的结果数据进行分类。
医疗助理的新角色包括健康教练、医疗抄写员、双重角色翻译员、健康导航员、小组经理、交叉培训灵活角色和主管。新角色的实施需要广泛的培训。医疗助理的激励措施和增加的薪酬因角色类型而异。
医疗助理的新角色是改革工作流程和减轻初级护理提供者负担的更大尝试的一部分。尽管有一些成功的证据,但推广范围有限。采用的关键挑战包括领导层和提供者对变革的抵制、额外医疗助理培训的成本以及非计费服务缺乏报销。