The strategic nature of individual change behavior: How physicians and their staff implement medical home care

Abstract

The findings show that particular forms of PCMH work not only advance patient care in favorable ways but also enhance individual and organizational capacity for adapting to this innovative model and its demands. This knowledge adds to our understanding of how to implement PCMH care in ways that are good for workers, primary care organizations, and patients and offers practical guidance as to which forms of PCMH work should be encouraged, incented, and rewarded.

Satisfaction, Burnout, and Turnover Among Nurse Practitioners and Physician Assistants: A Review of the Empirical Literature

“…“Talent management” is concerned specifically with promoting workers’ ability to reach their fullest potential through attention to job structures, workplace design, and individual needs and preferences (Lewis & Heckmen, 2006). With respect to the health care industry, it is increasingly important, given workforce shortages and the high levels of turnover and dissatisfaction seen in some professional and semiskilled roles, to adopt a more “strategic” approach to human resource management (Hoff & Scott, 2017). Generally, the costs of recruiting and developing workers, especially those at the level of clinical staff such as physicians, NPs, and PAs may cost organizations upward of 100% of the yearly pay for that particular worker (Cascio, 2006).…”

Evaluation of PCMH Model Adoption on Teamwork and Impact on Patient Access and Safety

“…18 Good teamwork in a PCMH is critical to sustaining patient-physician/practice relationships and ensuring continuity and reduced unnecessary utilization. 22,23 The persistence of and the improvement in team functioning at the PCMH despite reduced practice supports is encouraging and, supports the continued efforts at practice transformation. 24 Teamwork is critical to deflecting nonphysician work to other members of the team and allowing greater availability in the physicians' schedule.…”

“…24 Teamwork is critical to deflecting nonphysician work to other members of the team and allowing greater availability in the physicians' schedule. 23 In addition, use of practitioners and nurses in PCMH teams allows for greater patient access to meet their health care needs. 25 Improvement of patient safety: Teamwork continues to improve significantly in communication within teams, specifically, "staff follow a standardized method of sharing information when handing off patients," "staff relay relevant information in a timely manner."…”

What matters in patient-centered medical home transformation: Whole system evaluation outcomes of the Brown Primary Care Transformation Initiative

“…Designing and implementing PCMH components is hard work, involving modifications in practice culture as well as the mindsets and behaviors of those working in the practice. 10 , 43 , 46 …”

“…While best practices for PCMH implementation have been promoted, it has also been recognized that a single facilitation design or PCMH content list will not suit all PCMH endeavors. [41][42][43][44][45] Our evaluation of eight varying types and sizes of primary care practices, using both quantitative and qualitative methods, attempted to identify elements of PCMH transformation processes that were important to providers and staff and that may influence patients' experiences. Providers and staff in our study described the effect of the on-site PCMH transformation facilitation process as both adding to and detracting from the essence of how they perceive their practice.…”