PCMH Health Workforce- in Montana Community Health Centers

PCMH Health Workforce-in Montana Community Health Centers

Paula Block, RNMontana Primary Care Association,[email protected] / 406.442.2750

Montana Community Health Centers

Clinic Mighty Mouse- workforce

Workforce Changes Focus on Team that really supports patient care processes

and provider work- using MAs or Medical Assistants 2 MAs per provider, one doing direct care and other

administrative supportMA leads the daily team huddle, (have done the pre-work,

know patient needs) MAs- coordinate clinic flow and operations. (MAs empowered

once they know expectations and the big picture.) ‘Quality Nurse’- population management & QI Standardized workflows & defined job duties (backed by

standing orders)

Clinic Mighty Mouse- training Training Needs

On-line web program for staff office training, (includes PCMH type trainings such as cultural competency, goal setting, patient safety, motivational interviewing, care planning)

Providers assess clinical support staff training needs and help train

Communication emphasis for all on ‘how to talk to patients’ (helps spread PCMH message to patients)

Clinic Big & Beautiful- workforce

Workforce Changes Strategic planning on PCMH tenets of care

Who does work now? Can we ‘back it up’? (receptionist prints med list for patient to review with nurse)

Ongoing and continual review & re-review! Care teams

Share office, (providers, MAs, nurse, admin assistant, & more)

Nurse leader of patient care team Use ‘Special Teams’- lab, x-ray, triage, outreachChart & dictation staff now part of team as admin support

Use EHR in disciplined, structured, supporting way

Clinic Big & Beautiful- training Training Needs

Microsoft Excel- nurses and MAs (sort & filter skills needed for population management)

Facilitative Leadership- management staff

EHR- ongoing Lean / other QI improvement models,

communication, IHI team based care, motivational interviewing, patient self management, behavioral change, population management, health literacy, using evidence to improve care

Tool- Team Visualization or “Jelly Beans”

See AHRQ site “Implementing Care Teams”, for directions

Below is a common result

Tool- Task Assignments

See AHRQ’s “Implementing Care Teams” for directions Above is an example Ask 3 questions

What is task? Who does it now? In perfect world, who could do it?

Task Who does it? Who could do it?Book appointments RNs, Clerical ClericalTriage RNs & MDs RNsMed refills RN, MDs & clerical Clerical with MDSuture removal MD RNDressing change MD, RN MA

Resources Facilitative Leadership, www.interactonassociates.com Team exercises on AHRQ, under “Implementing Care

Teams”, http://www.ahrq.gov/professionals/prevention-chronic-care/improve/system/pfhandbook/mod19.html

Lean for health care, http://leanhealthcarewest.com/ IHI, (Institute for Healthcare Improvement), www.ihi.org Web on-line learning example, www.essentiallearning.com Goal setting, Comprehensive Motivational Interventions,

www.comprehensivemi.com/about/brief-action-planning