VA Office of Patient Care Services, Primary Care Analytics Team-Iowa City, Iowa City VA Health Care System, Iowa City, IA, USA.
Center for Mental Healthcare & Outcomes Research (CeMHOR), Central Arkansas Veterans Healthcare System, 2200 Fort Roots Rd., Bldg 58, North Little Rock, AR, 72114, USA.
BMC Med Educ. 2021 Mar 6;21(1):147. doi: 10.1186/s12909-021-02567-1.
Learning healthcare systems have invested heavily in training primary care staff to provide care using patient-centered medical home models, but less is known about how to effectively lead such teams to deliver high quality care. Research is needed to better understand which healthcare leadership skills are most utilized or in need of development through additional training.
Semi-structured telephone interviews with healthcare leaders familiar with Patient-Aligned Care Teams (PACT) implementation in the U.S. Department of Veterans Affairs (VA). We interviewed sixteen (N = 16) physician, nursing, and administrative leaders at VA facilities located in the upper Midwestern United States. Content analysis of interviews transcripts using template techniques.
Participants described instrumental challenges that they perceived hindered leadership effectiveness, including the supervisory structure; pace of change; complexity of the clinical data infrastructure; an over-reliance on technology for communication; and gaps in available leadership training. Factors perceived as facilitating effective leadership included training in soft skills, face-to-face communication, and opportunities for formal training and mentorship. A cross-cutting theme was the importance of developing "soft skills" for effective PACT leadership.
Although formal leadership training and development were perceived as beneficial, healthcare leaders familiar with PACT implementation in the VA described a mismatch between the skills and knowledge PACT leaders need to succeed and the training available to them. Closing this gap could improve retention of skilled and knowledgeable healthcare leaders, thereby reducing the costs associated with training and leading to improvements in healthcare delivery.
学习医疗保健系统在培训初级保健人员方面投入了大量资金,以使用以患者为中心的医疗之家模式提供护理,但对于如何有效地领导这些团队提供高质量的护理知之甚少。需要研究以更好地了解哪些医疗保健领导技能最常被使用或需要通过额外的培训来发展。
对熟悉美国退伍军人事务部(VA)中患者一致护理团队(PACT)实施情况的医疗保健领导者进行半结构化电话访谈。我们采访了位于美国中西部地区的 VA 设施的 16 名(N=16)医生、护理和行政领导。使用模板技术对访谈记录进行内容分析。
参与者描述了他们认为阻碍领导力有效性的工具性挑战,包括监督结构;变革的步伐;临床数据基础设施的复杂性;对技术的过度依赖用于沟通;以及可用领导力培训的差距。被认为有助于有效领导的因素包括软技能培训、面对面沟通以及正式培训和指导的机会。一个贯穿始终的主题是为有效的 PACT 领导力发展“软技能”的重要性。
尽管正式的领导力培训和发展被认为是有益的,但熟悉 VA 中 PACT 实施的医疗保健领导者描述了 PACT 领导者成功所需的技能和知识与可用培训之间存在不匹配。缩小这一差距可以提高熟练且知识渊博的医疗保健领导者的留任率,从而降低培训相关成本,并改善医疗服务的提供。