Task Delegation and Burnout Trade-offs Among Primary Care Providers and Nurses in Veterans Affairs Patient Aligned Care Teams (VA PACTs)

Abstract

Purpose: Appropriate delegation of clinical tasks from primary care providers (PCPs) to other team members may reduce employee burnout in primary care. However, (1) the extent to which delegation occurs within multidisciplinary teams, (2) factors associated with greater delegation, and (3) whether delegation is associated with burnout are all unknown.Methods: We performed a national cross-sectional survey of Veterans Affairs (VA) PCP-nurse dyads in Department of VA primary care clinics, 4 years into the VA's patient-centered medical home initiative. PCPs reported the extent to which they relied on other team members to complete 15 common primary care tasks; paired nurses reported how much they were relied on to complete the same tasks. A composite score of task delegation/reliance was developed by taking the average of the responses to the 15 questions. We performed multivariable regression to explore predictors of task delegation and burnout. Results: Among 777 PCP-nurse dyads, PCPs reported delegating tasks less than nurses reported being relied on (PCP mean

Occupational stress and engagement in primary health care workers

“…The percentage of workers with significant levels of stress found in this study is consistent with other studies, which indicate high levels of stress among PHC workers, confirming that workers are affected by problems or damages to their physical and mental health (21,(26)(27)(28)(29)(30) .…”

Physician and Nurse Practitioner Teamwork Sustains the Primary Care Workforce

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Barriers and Facilitators to Expanding Roles of Medical Assistants in Patient-Centered Medical Homes (PCMHs)

“…This is similar to a study conducted in the Veterans Administration system, which found that task delegation from primary care physicians to nurses resulted in more burnout in the nurses. 26 Our study offers some insights into how to make role changes more favorably viewed by MAs.…”