Want to take quizzes and track your credits?
North Shore Physicians Group (NSPG), a 20-site organization with 365 employed providers, began a system-wide change to a team-based care delivery model in which the physician leads the care team of closely aligned professionals, each having a different role in the care of the patient.
The model is based on an expanded role for medical assistants (MAs), “so that the physicians wouldn't have to shoulder all of the work,” said Beverly Loudin, MD, MPH, former NSPG Director of Patient Safety and Quality, and director of the initiative. Dr. Loudin began by interviewing physicians regarding the skills and responsibilities they would want in a highly functional MA.
Once the role was designed, NSPG developed a week-long training program to ensure that all MAs in the system would have the same skillset aligned with their new responsibilities.
The following year, NSPG trained 80 MAs in the new model of care. They were taught additional clinical skills, health coaching, patient self-management techniques, and population management. MAs were also trained in process improvement methods.
The MA role transitioned to a care team partner within the practice. Each day, the physician, nurse, MA, and scheduler start with a morning huddle to review the coming day's schedule to plan for a smooth workflow. The rooming process previously took three minutes, but was expanded to an eight-minute process to include recording current medications and allergies, agenda-setting, form completion, and closing gaps in care (also known as “in-reach approach”). For example, the MAs review all health monitoring reminders, give immunizations, and proactively book appointments for preventive care. The goal is to identify patient needs while in the exam room, rather than leaving time-consuming loose ends to be addressed after the patient leaves.
The MA also assumes responsibility for documentation. As one NSPG leader reports, “a huge part of the change has been having the MA put extensive visit information into the electronic health record.” The MA starts the note and performs most of the structured text data entry components of the visit. The provider later edits these entries for accuracy and documents the narrative portion of the note.
In-reach approachIn-reach approach:
Planning in advance so that care gaps are closed at the time of each face-to-face visit.
AMA STEPS Forward® presents actionable, practical toolkits and customizable resources that you can use to successfully implement meaningful and transformative change in your practice or organization. See How it Works
Disclaimer: AMA STEPS Forward® content is provided for informational purposes only, is believed to be current and accurate at the time of posting, and is not intended as, and should not be construed to be, legal, financial, medical, or consulting advice. Physicians and other users should seek competent legal, financial, medical, and consulting advice. AMA STEPS Forward® content provides information on commercial products, processes, and services for informational purposes only. The AMA does not endorse or recommend any commercial products, processes, or services and mention of the same in AMA STEPS Forward® content is not an endorsement or recommendation. The AMA hereby disclaims all express and implied warranties of any kind related to any third-party content or offering. The AMA expressly disclaims all liability for damages of any kind arising out of use, reference to, or reliance on AMA STEPS Forward® content.
You currently have no searches saved.
You currently have no courses saved.