Primary Care Staff Perspectives on a Virtual Learning Collaborative to Support Medical Home Implementation

Butler, Anneliese; Canamucio, Anne; Macpherson, David S.; Skoko, Jennifer; True, Gala

doi:10.1007/s11606-013-2668-x

Cited by 24 publications

(35 citation statements)

References 20 publications

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“…Because PCPs drove delegation of tasks downwardly through a licensure hierarchy in the team, nurse implementation was constrained by PCPs' level of adoption (24). As other research in VA has demonstrated, status differences may be inadvertently reinforced by informal policies which prioritized training for PCPs and RNs over that for LPNs and administrative associates (25).…”

Section: Discussionmentioning

confidence: 99%

Implications of the Patient-Centered Medical Home for Nursing Practice

Stewart

Lampman

et al. 2015

JONA: The Journal of Nursing Administration

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Section: Discussionmentioning

confidence: 99%

Implications of the Patient-Centered Medical Home for Nursing Practice

Stewart

Lampman

et al. 2015

JONA: The Journal of Nursing Administration

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“…Yet, not only were clerks less able to secure time away from their workstations to participate in either local activities or the regional training events, our review of the training materials identified little content that was directly applicable their role (see also Butler et al. ). As a rough measure of relevance, we compared the frequency of role mentions in presentations and documents provided at five in‐person team training events and found that less than 1% referenced clerks.…”

Section: Spatial Organization As a Sign Of Carementioning

confidence: 99%

Gatekeepers as Care Providers: The Care Work of Patient‐centered Medical Home Clerical Staff

et al. 2016

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International implementation of the patient-centered medical home (PCMH) model for delivering primary care has dramatically increased in the last decade. A majority of research on PCMH's impact has emphasized the care provided by clinically trained staff. In this article, we report our ethnographic analysis of data collected from Department of Veterans Affairs staff implementing PACT, the VA version of PCMH. Teams were trained to use within-team delegation, largely accomplished through attention to clinical licensure, to differentiate staff in providing efficient, patient-centered care. In doing so, PACT may reinforce a clinically defined culture of care that countermands PCMH ideals. Such competing rubrics for care are brought into relief through a focus on the care work performed by clerks. Ethnographic analysis identifies clerks' care as a kind of emotional dirty work, signaling important areas for future anthropological study of the relationships among patient-centered care, stigma, and clinical authority.

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“…Virtual Collaborative participants with prior training and those who participated in all components of the training reported benefiting greatly from the training especially from the opportunity to share experiences; however those without previous training and non-clinicians suggested the content did not meet their needs and reported barriers to full participation such as lack of protected time and inadequate leadership support to attend. 1 Fundamental to PACT is a solid comprehensive team orientation, with documented staff competencies assessed at periodic time points through direct observation; to promote consistency among staff and to ensure the established PACT principles and protocols are followed. Staff are required to be educated and trained on the major principles of PACT and expectations of care provision using this model.…”

Section: Trainingmentioning

confidence: 99%