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以患者为中心的医疗之家工作人员团队成员在跨专业培训环境中的工作经历。

Experiences of Patient-Centered Medical Home Staff Team Members Working in Interprofessional Training Environments.

作者信息

Newell Summer, O'Brien Bridget, Brienza Rebecca, Dulay Maya, Strewler Anna, Manuel Jennifer K, Tuepker Anaïs

机构信息

Center to Improve Veteran Involvement in Care (CIVIC), VA Portland Healthcare System , Portland, OR, USA.

VA San Francisco Healthcare System , San Francisco, CA, USA.

出版信息

J Gen Intern Med. 2020 Oct;35(10):2976-2982. doi: 10.1007/s11606-020-06055-y. Epub 2020 Jul 29.

Abstract

BACKGROUND

Evidence is growing that interprofessional team-based models benefit providers, trainees, and patients, but less is understood about the experiences of staff who work beside trainees learning these models.

OBJECTIVE

To understand the experiences of staff in five VA training clinics participating in an interprofessional team-based learning initiative.

DESIGN

Individual semi-structured interviews with staff were conducted during site visits, qualitatively coded, and analyzed for themes across sites and participant groups.

PARTICIPANTS

Patient-centered medical home (PCMH) staff members (n = 32; RNs, Clinical and Clerical Associates) in non-primary care provider (PCP) roles working on teams with trainees from medicine, nursing, pharmacy, and psychology.

APPROACH

Benefits and challenges of working in an interprofessional, academic clinic were coded by the primary author using a hybrid inductive/directed thematic analytic approach, with review and iterative theme development by the interprofessional author team.

KEY RESULTS

Efforts to improve interprofessional collaboration among trainees and providers, such as increased shared leadership, have positive spillover effects for PCMH staff members. These staff members perceive themselves playing an educational role for trainees that is not always acknowledged. Playing this role, learning from the "fresh" knowledge imparted by trainees, and contributing to the future of health care all bring satisfaction to staff members. Some constraints exist for full participation in the educational efforts of the clinic.

CONCLUSIONS

Increased recognition of and expanded support for PCMH staff members to participate in educational endeavors is essential as interprofessional training clinics grow.

摘要

背景

越来越多的证据表明,跨专业团队模式对医疗服务提供者、实习生和患者有益,但对于在实习生旁边学习这些模式的工作人员的经历了解较少。

目的

了解五家退伍军人事务部(VA)培训诊所中参与跨专业团队学习计划的工作人员的经历。

设计

在实地考察期间对工作人员进行了个人半结构化访谈,进行定性编码,并分析各地点和参与者群体的主题。

参与者

以患者为中心的医疗之家(PCMH)工作人员(n = 32;注册护士、临床和文书助理),他们在非初级保健提供者(PCP)岗位上与来自医学、护理、药学和心理学的实习生一起工作。

方法

主要作者采用归纳/定向混合主题分析方法对在跨专业学术诊所工作的益处和挑战进行编码,跨专业作者团队进行审查和反复的主题开发。

主要结果

改善实习生和医疗服务提供者之间跨专业协作的努力,如增加共同领导,对PCMH工作人员有积极的溢出效应。这些工作人员认为自己在为实习生发挥教育作用,但这种作用并不总是得到认可。扮演这个角色、从实习生传授的“新鲜”知识中学习以及为医疗保健的未来做出贡献都给工作人员带来了满足感。在充分参与诊所的教育工作方面存在一些限制。

结论

随着跨专业培训诊所的发展,提高对PCMH工作人员参与教育工作的认识并扩大对他们的支持至关重要。

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