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Workflow and Process Module 0.5 Credit CME

Medical Assistant Professional DevelopmentEnhance the roles of front-line staff, and improve your practice culture, workflow and team dynamics.

Team-Based Learning
Learning Objectives:
At the end of this activity, you will be able to:
1. Identify steps to begin a medical assistant (MA) professional development program in your practice
2. Describe best practices on developing a professional development training curriculum and materials
3. Explain how to execute and evaluate an MA professional development program

STEPS Forward™ is a practice improvement initiative from the AMA designed to empower teams like yours to identify and attain appropriate goals and tactics well matched to your practice’s specific needs and environment. Wherever you find your team on the practice improvement continuum, the American Medical Association can help you take the next steps – the right steps – to improve your practice. Learn more

How will this module help me create, implement and evaluate a medical assistant (MA) professional development program?

  1. Four STEPS for beginning an MA professional development program

  2. Answers to commonly asked questions

  3. Examples of practices that have provided professional development for their MAs

Introduction

Medical assistants (MAs) are at the front line of patient care and play an integral role in achieving practice goals such as increased patient satisfaction, improved quality and enhanced team-based care. You can enable MAs to contribute in a more meaningful way to the practice team through professional development training.

“I never realized that when a patient says ‘I left my glasses at home – can you help me with this form' she may be covering for the fact she can't read or understand the paperwork. I'll be more aware of this in the future.”

An MA after completion of the Health Literacy training session
Four STEPS for beginning an MA professional development program in your practice

  1. Poll the team and prioritize training topics

  2. Select a program leader

  3. Assemble the curriculum and educational materials

  4. Execute and evaluate the training

Step 1 Poll the team and prioritize training topics

Quiz Ref IDGather your practice team and ensure that you have their full support for a monthly MA professional development series. Survey the team to understand where they see gaps in care, breakdowns in practice workflow and other opportunities for training or development. From this comprehensive list, select approximately ten training topics to be covered during the first year of your program. Prioritize the topics that are most important to your team.

MA inservice education survey
Box Section Ref ID

Q&A

  • Who should fill out the survey to identify training opportunities?

    Combining the unique perspectives of individual practice team members will help provide a more comprehensive set of information to identify and prioritize MA professional development topics. Involve physicians, MAs, nurses, registration staff and other members of the team. Ask patients to complete the survey, or use their feedback from satisfaction surveys as a way to include their input. Consider involving practice or system leadership as well.

  • How much of a time commitment is the training?

    Make the commitment to provide MA professional development monthly for at least one year. Each session should be 45 minutes to one hour. Before starting the program, prepare to spend time on content development and creating space in the schedule for the hour-long lunchtime or pre-clinic sessions.

  • How can providing education to MAs improve the experience of physicians, other staff and patients in our practice?

    Shifting some of the physicians' administrative and clinical tasks to well-trained MAs gives physicians more time to concentrate on the patient during visits. For example, a patient who has been properly roomed by a well-trained MA will have the following:

    • Updated patient, family and social history

    • Updated screening information

    • Completed medication reconciliation with questions or concerns about medications identified

    • Records from specialists or other facilities scanned into the chart

    • Accurate vital signs

    • Standing orders placed

  • What are some examples of MA professional development topics that other practices have selected?

    Examples of training categories include practice improvement, enhanced work flows, chronic disease management and healthy staff goals.

    The following topics are covered by materials in this module:

    • Professionalism in the MA role

    • Diabetes management and prevention

    • Health literacy

    • Hypertension, obesity and hyperlipidemia

    • Hospice

    • Chronic kidney disease

    You may also want to consider developing your own materials on:

    • Panel/population health management

    • Cancer screening criteria

    • Conducting behavioral health screens

    • Delivering normal laboratory results

    • Community resources for patients

Complete medical assistant professional development toolkit
Step 2 Select a program leader

The MA professional development program leader should have an interest in continuing education and strong clinical skills. In many practices, the leader will be a nurse. In others, it may be a physician assistant, nurse practitioner, nurse care coordinator or MA supervisor.

Box Section Ref ID

Q&A

  • What will the program leader's role entail?

    The program leader will work with other practice stakeholders, such as physicians and the MA supervisor, to assemble the curriculum and materials for each session. The program leader's responsibilities may include:

    • Scheduling sessions during dedicated times

    • Facilitating and leading trainings

    • Adapting content and materials to fit your practice's needs

    • Coordinating with guest presenters

Step 3 Assemble the curriculum and educational materials

The educational materials you use during the MA professional development sessions should be concise and straightforward. Flashcards that define the topic and contain essential information or an outline of the content that will be covered, make excellent pre-session learning tools. Handouts, activities and teaching aids are ideal to use for the session itself. All of these materials and tactics will enable the MAs to grasp, retain and revisit the information covered in the session.

At the end of each session, share tools to help the MAs apply their new knowledge. For example, if the MAs learned about diabetes management, consider practicing with a sample script for having conversations with patients about diabetes management or instructions on when to involve the diabetes educator.

Supplemental flashcards - basic medical knowledge
Box Section Ref ID

Q&A

Step 4 Execute and evaluate the training

Communicate to your MAs about the new professional development program, what they can expect from the sessions and what will be expected of them. The rest of the practice team should also be aware of when the professional development sessions will occur. The sessions should occur during working hours, and the MAs should be told whether they should bring their breakfast or lunch to the session. Start and end on time.

Check in with physicians and other team members on a regular basis to see if the training is helping the MAs gain new competencies and improve their performance in the practice. Use feedback to continue to improve the professional development series. As MA competencies and capabilities evolve, augment MA roles as appropriate and in compliance with applicable laws.

Box Section Ref ID

Q&A

  • How should we make sure the training sessions are successful from the MAs' perspective?

    Check in with the MAs regularly:

    • Play games or do activities to test and reinforce the teachings at the end of each session.

    • Administer a brief survey (five questions or fewer) at the end of each session to make sure the content and format are working.

    • Use verbal teach-back style questioning to confirm the impact of the training. If you're using this approach, you might ask, “What are the three most important things you learned about health literacy?”

    • Give a follow-up survey at the end of the year-long program to see what sessions resonated most with the MAs and how they are using what they learned in their daily work. At this point, it might be worth revisiting a popular topic or one that requires some additional reinforcement.

  • How should we evaluate the program?

    Qualitative data from the session evaluations can indicate the effect of the program on MA confidence, understanding of clinic workflows, performance in the MA role and feelings of job satisfaction. These are easy to measure and provide valuable insight. You may also consider gathering feedback from the MAs and other care team members using end-of-year surveys.

    Monitor any new skills or processes that should be used regularly after each session, such as a new protocol for documenting information in the medical record or a better approach to measuring blood pressure during the rooming process. A practice coach (who could be the person who gave the training or another member of the practice team) or the MA supervisor can shadow the MAs to ensure that they understand and are using the new skill or process. These audits give the opportunity for on-the-spot coaching. Your practice may also choose to monitor metrics on your patient satisfaction survey related to MA professionalism and clinical care.

  • How can we maximize the impact of our program?

    Involve an interdisciplinary team when executing the program in your practice; this approach lends credibility to the program and promotes success. Consider linking sessions to other practice activities to improve engagement. For example, if your clinic sees many patients with diabetes, hold training on the importance of preparing patients for diabetic foot exams in November to coincide with National Diabetes Month. You may also consider connecting your training topics to statewide or national health initiatives, such as Healthy People 2020.

    Team-based presentations may help your MAs get the most out of the training. Bringing in outside speakers who are experts on various topics, such as a nurse practitioner with hospice experience, or having a team of two staff members present on a pilot that they've been involved in can be very effective in engaging MAs.

  • Do we need to pilot the new program or can we roll it out all at once?

    If your practice wants to start out on a smaller scale, consider piloting the MA professional development program in a couple of pods or teams within the clinic. Five or six MAs would be able to give valuable feedback about the teaching methods and delivery of material in these pilot sessions. Depending on how often you decide to hold sessions, plan to run the pilot for four to six sessions or up to six months. Communicate with the other MAs and teams in the practice that are not part of the pilot so they know that they will be included in the program's official rollout.

AMA Pearls
Get input from the MAs on their training needs

Take into account your MAs' interests and needs when developing your curriculum. Lessons personalized for your team will be well received.

Training promotes life-long learning for MAs

Life-long learning is a crucial aspect of developing a strong team, similar to the educational commitment that physicians, nurses and other providers make. MA professional development programs mirror the continuing education that others in your clinic receive.

Conclusion

Professional development training is a valuable tool to engage and educate your MA team. Making the effort to develop tailored lessons can improve your practice culture, workflow and team dynamics. A team of well-trained MAs can enable the practice to adopt a team-based care model, take better care of patients with greater efficiency and increase satisfaction for all members of the care team as well as patients.

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Where CME credit is designated, the activity is part of the American Medical Association's accredited CME program. The AMA is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
Article Information

*Disclaimer: Always obtain appropriate usage rights for training materials.

Target Audience: This activity is designed to meet the educational needs of practicing physicians.

Statement of Competency: This activity is designed to address the following ABMS/ACGME competencies: practice-based learning and improvement, interpersonal and communications skills, professionalism, systems-based practice and also address interdisciplinary teamwork and quality improvement.

Planning Committee:

  • Alejandro Aparicio, MD, Director, Medical Education Programs, AMA

  • Rita LePard, CME Program Committee, AMA

  • Becca Moran, MPH, Program Administrator, Professional Satisfaction and Practice Sustainability, AMA

  • Ellie Rajcevich, MPA, Practice Development Advisor, Professional Satisfaction and Practice Sustainability, AMA

  • Sam Reynolds, MBA, Director, Professional Satisfaction and Practice Sustainability, AMA

  • Christine Sinsky, MD, Vice President, Professional Satisfaction, American Medical Association and Internist, Medical Associates Clinic and Health Plans, Dubuque, IA

Author Affiliations:

  • Janet Duni, RN, MPA, Director of Care Coordination, Vanguard Medical Group, Verona, NJ

Faculty:

  • Cathryn B. Heath, MD, FAAFP, Clinical Associate Professor of Family Medicine, Department of Family Medicine and Community Health, Rutgers - Robert Wood Johnson Medical School; Steven Peskin, MD, MBA, FACP, Executive Medical Director, Population Health, Horizon BCBSNJ; Ellie Rajcevich, MPA, Practice Development Advisor, Professional Satisfaction and Practice Sustainability, AMA; Becca Moran, MPH, Program Administrator, Professional Satisfaction and Practice Sustainability, AMA; Christine Sinsky, MD, Vice President, Professional Satisfaction, American Medical Association and Internist, Medical Associates Clinic and Health Plans, Dubuque, IA

About the Professional Satisfaction, Practice Sustainability Group: The AMA Professional Satisfaction and Practice Sustainability group has been tasked with developing and promoting innovative strategies that create sustainable practices. Leveraging findings from the 2013 AMA/RAND Health study, “Factors affecting physician professional satisfaction and their implications for patient care, health systems and health policy,” and other research sources, the group developed a series of practice transformation strategies. Each has the potential to reduce or eliminate inefficiency in broader office-based physician practices and improve health outcomes, increase operational productivity and reduce health care costs.

Disclosure Statement: The content of this activity does not relate to any product of a commercial interest as defined by the ACCME; therefore, neither the planners nor the faculty have relevant financial relationships to disclose.

References
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The American Medical Association Foundation.  Health literacy and patient safety: help patients understand [video]. https://www.youtube.com/watch?v=cGtTZ_vxjyA. Published August27 , 2010. Accessed November 19, 2015.
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Agency for Healthcare Research and Quality.  Health literacy universal precautions toolkit. http://www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/quality-resources/tools/literacy-toolkit/healthliteracytoolkit.pdf. Published April2010. Accessed November 20, 2015.
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Centers for Disease Control and Prevention.  Health literacy. http://www.cdc.gov/healthliteracy/. Updated October8 , 2015. Accessed November 19, 2015.
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Harvard University, T.H. Chan School of Public Health.  Health literacy studies. http://www.hsph.harvard.edu/healthliteracy/resources/. Accessed November 19, 2015.
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Merriman  B.  Health literacy in the information age: communicating cancer information to patients and families.  CA Cancer J Clin. 2002;52(3):130–133. http://onlinelibrary.wiley.com/doi/10.3322/canjclin.52.3.130/abstract;jsessionid=8A1250680B6919B89F27A7DD4EC20AE4.f02t03.Google ScholarCrossref
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Glassman  P.  National Network of Libraries of Medicine.  Health literacy. http://nnlm.gov/outreach/consumer/hlthlit.html. Published June2013. Accessed November 19, 2015.Google Scholar
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US Department of Health and Human Services, Office of Disease Prevention and Health Promotion.  Health communication activities. www/health.gov/communication/literacy. Updated July24 , 2008. Accessed November 19, 2015.
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Vanguard Medical Group.  Health library. http://www.vanguardmedgroup.com/index.php?p=health-library. Accessed November 19, 2015.
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National Kidney Foundation.  Understanding your lab values. https://www.kidney.org/kidneydisease/understandinglabvalues. Accessed November 19, 2015.
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Mayo Clinic.  Chronic kidney disease. http://www.mayoclinic.org/diseases-conditions/kidney-disease/basics/definition/con-20026778. Updated January30 , 2015. Accessed November 19, 2015.
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National Institutes of Health, US National Library of Medicine.  Chronic kidney disease. https://www.nlm.nih.gov/medlineplus/chronickidneydisease.html. Accessed November 19, 2015.
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