JOURNAL OF AMBULATORY CARE MANAGEMENT最新文献

The nurse practitioner (NP) workforce in community health centers (CHCs) increases access to primary care for underserved populations. Working with medically complex patients, high workloads, and low resources in the CHC setting, CHC NPs may be susceptible to poor workforce outcomes. This study uses NP survey data collected from 6 US states to describe and assess the relationship between CHC NP practice environment and burnout, job satisfaction, and turnover intention. CHC NPs rated their practice environments favorably, and more than 89% of CHC NPs reported satisfaction with their job. Better rating of NPs' relationship with CHC administration was associated with improved job satisfaction and decreased turnover intention.

Primary care clerical staff may experience burnout if not adequately prepared and supported for patient-facing customer service tasks. Guided by the Job Demands-Resources (JD-R) model, we use national survey data from 707 primary care clerks at 349 VA clinics (2018; response rate: 12%) to evaluate associations between clerks' perceptions of tasks, work environment, training, and burnout. We found challenges with customer-facing tasks contribute to higher burnout, and supportive work environment was associated with lower burnout. Although perceptions of training were not associated with burnout, our results combined with the JD-R model suggest that customer service training may protect against burnout.

Medical assistants (MAs) are among the fastest-growing occupations in the United States, yet health care employers report high turnover rates and difficulty filling MA positions. Employers are increasingly using apprenticeship to meet emerging workforce needs. This qualitative study examined the perspectives of 14 employers using registered MA apprenticeships in 8 states. The findings revealed motivations for using apprenticeship, perceived benefits to the organization, challenges with implementation, and reflections on successful implementation. We detail how MA apprenticeship is successfully meeting recruitment and training needs in a variety of health care organizations, especially where program support resources are available.

Using data from a Veterans Health Administration national primary care survey, this study identified the most highly rated tools and care approaches for patients with complex needs and how preferences varied by professional role, staffing, and training. Nurses were significantly more likely to rate most tools as very important as compared with primary care providers. Having a fully staffed team was also significantly associated with a very important rating on all tools. Nurses and fully staffed teams reported a greater likeliness to use most care approaches, and those with perceived need for training reporting a lower likeliness to use.

So-called "geographic expansion race," health care organizations expand physical facilities to different geographical locations as a way to foster growth. This study furthers knowledge on Federally Qualified Health Centers' (FQHCs') geographical expansion in relation to the local market's payer mix. The results indicated that areas with a higher proportion of Medicaid patients with fewer uninsured are more likely to see new FQHC sites opening. The findings are consistent with previous literature on the health care organization's geographical expansion and also indicated that some areas might lack proper FQHC services despite the high needs.