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Association between medical home characteristics and staff professional experiences in pediatric practices.

Knapp C, Chakravorty S, Madden V, Baron-Lee J, Gubernick R, Kairys S, Pelaez-Velez C, Sanders LM, Thompson L - Arch Public Health (2014)

Bottom Line: Chronic condition and data management are associated with lower burnout (OR = 0.05 and 0.20, respectively).Across all models adaptive reserve, or the ability to make and sustain change, is associated with higher job satisfaction and lower staff burnout.Although our study is cross-sectional, it provides some insight about how medical home, staff and practice characteristics are associated with job satisfaction and burnout.

View Article: PubMed Central - PubMed

Affiliation: Department of Health Outcomes and Policy, University of Florida, 1329 SW 16th St, Gainesville, FL 32608 USA.

ABSTRACT

Background: The patient-centered medical home (PCMH) model has been touted as a potential way to improve primary care. As more PCMH projects are undertaken it is critical to understand professional experiences as staff are key in implementing and maintaining the necessary changes. A paucity of information on staff experiences is available, and our study aims to fill that critical gap in the literature.

Methods: Eligible pediatric practices were invited to participate in the Florida Pediatric Medical Home Demonstration Project out which 20 practices were selected. Eligibility criteria included a minimum of 100 children with special health care needs and participation in Medicaid, a Medicaid health plan, or Florida KidCare. Survey data were collected from staff working in these 20 pediatric practices across Florida. Ware's seven-point scale assessed satisfaction and burnout was measured using the six-point Maslach scale. The Medical Home Index measured the practice's medical home characteristics. Descriptive and multivariate analyses were conducted. In total, 170 staff members completed the survey and the response rate was 42.6%.

Results: Staff members reported high job satisfaction (mean 5.54; SD 1.26) and average burnout. Multivariate analyses suggest that care coordination is positively associated (b = 0.75) and community outreach is negatively associated (b = -0.18) with job satisfaction. Quality improvement and organizational capacity are positively associated with increased staff burnout (OR = 1.37, 5.89, respectively). Chronic condition and data management are associated with lower burnout (OR = 0.05 and 0.20, respectively). Across all models adaptive reserve, or the ability to make and sustain change, is associated with higher job satisfaction and lower staff burnout.

Conclusions: Staff experiences in the transition to becoming a PCMH are important. Although our study is cross-sectional, it provides some insight about how medical home, staff and practice characteristics are associated with job satisfaction and burnout. Many PCMH initiatives include facilitation and it should assist staff on how to adapt to change. Unless staff needs are addressed a PCMH may be threatened by fatigue, burnout, and low morale.

No MeSH data available.


Related in: MedlinePlus

Data used in the study and their sources.
© Copyright Policy - open-access
Related In: Results  -  Collection

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Fig1: Data used in the study and their sources.

Mentions: Baseline staff surveys are the primary data used in this cross sectional study. Between October and November 2011 staff at each of the 20 practices was given hard copy surveys to complete. All staff was asked to participate regardless of position. Staff was given a packet that included the survey, instructions for submission, and a return envelope. No incentives were given. It was requested that staff mail back the survey within 14 days. Reminders were sent via email at two, four, and six weeks. Flyers were posted in common areas of the practices to encourage staff participation. Overall, 170 surveys were completed (overall response rate 42.6%; by practice 13% to 100%).Data from the staff survey were matched to two supplemental datasets: 1) data from the practice’s original project application (which was completed and submitted by the core project team by 20 July 2011), and 2) data from the core project team survey completed between August and September 2011. Figure 1 describes the data sources. This study was approved by the Institutional Review Board at the University of Florida (#80-2011).Figure 1


Association between medical home characteristics and staff professional experiences in pediatric practices.

Knapp C, Chakravorty S, Madden V, Baron-Lee J, Gubernick R, Kairys S, Pelaez-Velez C, Sanders LM, Thompson L - Arch Public Health (2014)

Data used in the study and their sources.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4216343&req=5

Fig1: Data used in the study and their sources.
Mentions: Baseline staff surveys are the primary data used in this cross sectional study. Between October and November 2011 staff at each of the 20 practices was given hard copy surveys to complete. All staff was asked to participate regardless of position. Staff was given a packet that included the survey, instructions for submission, and a return envelope. No incentives were given. It was requested that staff mail back the survey within 14 days. Reminders were sent via email at two, four, and six weeks. Flyers were posted in common areas of the practices to encourage staff participation. Overall, 170 surveys were completed (overall response rate 42.6%; by practice 13% to 100%).Data from the staff survey were matched to two supplemental datasets: 1) data from the practice’s original project application (which was completed and submitted by the core project team by 20 July 2011), and 2) data from the core project team survey completed between August and September 2011. Figure 1 describes the data sources. This study was approved by the Institutional Review Board at the University of Florida (#80-2011).Figure 1

Bottom Line: Chronic condition and data management are associated with lower burnout (OR = 0.05 and 0.20, respectively).Across all models adaptive reserve, or the ability to make and sustain change, is associated with higher job satisfaction and lower staff burnout.Although our study is cross-sectional, it provides some insight about how medical home, staff and practice characteristics are associated with job satisfaction and burnout.

View Article: PubMed Central - PubMed

Affiliation: Department of Health Outcomes and Policy, University of Florida, 1329 SW 16th St, Gainesville, FL 32608 USA.

ABSTRACT

Background: The patient-centered medical home (PCMH) model has been touted as a potential way to improve primary care. As more PCMH projects are undertaken it is critical to understand professional experiences as staff are key in implementing and maintaining the necessary changes. A paucity of information on staff experiences is available, and our study aims to fill that critical gap in the literature.

Methods: Eligible pediatric practices were invited to participate in the Florida Pediatric Medical Home Demonstration Project out which 20 practices were selected. Eligibility criteria included a minimum of 100 children with special health care needs and participation in Medicaid, a Medicaid health plan, or Florida KidCare. Survey data were collected from staff working in these 20 pediatric practices across Florida. Ware's seven-point scale assessed satisfaction and burnout was measured using the six-point Maslach scale. The Medical Home Index measured the practice's medical home characteristics. Descriptive and multivariate analyses were conducted. In total, 170 staff members completed the survey and the response rate was 42.6%.

Results: Staff members reported high job satisfaction (mean 5.54; SD 1.26) and average burnout. Multivariate analyses suggest that care coordination is positively associated (b = 0.75) and community outreach is negatively associated (b = -0.18) with job satisfaction. Quality improvement and organizational capacity are positively associated with increased staff burnout (OR = 1.37, 5.89, respectively). Chronic condition and data management are associated with lower burnout (OR = 0.05 and 0.20, respectively). Across all models adaptive reserve, or the ability to make and sustain change, is associated with higher job satisfaction and lower staff burnout.

Conclusions: Staff experiences in the transition to becoming a PCMH are important. Although our study is cross-sectional, it provides some insight about how medical home, staff and practice characteristics are associated with job satisfaction and burnout. Many PCMH initiatives include facilitation and it should assist staff on how to adapt to change. Unless staff needs are addressed a PCMH may be threatened by fatigue, burnout, and low morale.

No MeSH data available.


Related in: MedlinePlus