PRACTITIONER APPLICATION: Activities and Sensemaking Associated With Frontline Role Expansion in Primary Care Settings.

Abstract

Over the past several decades, the Patient-Centered Medical Home (PCMH) model has evolved from an isolated, physician-focused approach to a collaborative method of care delivery. This shift in mentality empowers medical staff and patients to share information, anticipate needs, and attain a higher quality of care. Typically, primary care practices are the first point of contact for patients seeking treatment. To optimize the quality of these visits, I would encourage all primary care practices to stay connected with larger health systems and specialists in their communities. In this study, Hoff identifies numerous ways that the PCMH model can affect patient care. Examples include thorough medication reconciliation, frequent outreach to external specialists involved in their patient’s health, direct contact with patients for information prior to initial visits, and information sharing among primary care teams. One of the study’s significant conclusions is that physicians should allot time for team members to practice newly developed skills. He also posits that upskilling, or the teaching of additional skills, must be a regular component of continuing education for clinical and nonclinical personnel to combat burnout. What I find especially interesting about Hoff ’s research is that he demonstrates how the PCMH model approach expands the role of lower-level practitioners and affects them socially and psychologically. Clinicians interviewed in this study repeatedly mentioned the close bonds they formed with patients and coworkers because of the expansion of their roles. Healthcare organizations tackle many internal and external challenges, yet one area to be continually mindful of is staff development. Many frontline staff members get stuck in mundane routines that can stifle creative energy and team engagement. As a hospital manager and team leader, I would suggest that soft-skill development exerts a direct impact on employee engagement and retention at an organizational level, particularly in the current healthcare environment. I have been involved in numerous quality improvement projects that called for an expansion of clinical and administrative responsibilities, and they have benefited practitioners as well as their clinical teams. In one extensive project, we asked advanced practice providers to call patients before their first visit to understand their personal needs, establish rapport, anticipate and arrange future appointments, and truncate the amount of time spent completing treatment at our facility.