January 9, 2012
Sarah E. Lewis, M.S.P.H., Robert S. Nocon, M.H.S., Hui Tang, M.S., Seo Young Park, Ph.D., Anusha M. Vable, M.P.H., Lawrence P. Casalino, M.D., Ph.D., Elbert S. Huang, M.D., M.P.H., Michael T. Quinn, Ph.D., Deborah L. Burnet, M.D. M.A., Wm. Thomas Summerfelt, Ph.D., Jonathan M. Birnberg, M.D., Marshall H. Chin, M.D., M.P.H.
S. Lewis, R. S. Nocon, H. Tang et al., "Patient-Centered Medical Home Characteristics and Staff Morale in Safety Net Clinics," Archives of Internal Medicine, Jan. 9, 2012 172(1):23–31.
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When discussing the promise of the patient-centered medical home, policymakers and health care organizations primarily focus on the potential for improved outcomes for patients, who benefit from enhanced access to care, greater continuity in their provider relationship, and better coordination of care. But what effect does this model of primary care have on health care providers and clinical staff, in terms of morale, job satisfaction, and workload? Do they benefit from a more efficient and satisfying work environment, or, alternatively, do they suffer burnout from increased workloads and changes to their roles? This Commonwealth Fund–supported study surveyed providers and clinical staff at 65 community health centers during the first year of the Safety Net Medical Home Initiative, a five-year demonstration project to help health centers in five states transform into patient-centered medical homes.
What the Study Found
The study examined the association of five key characteristics of the patient-centered medical home—access to care, communication with patients, communication with other providers, tracking data, care management, and quality improvement—with providers and staff morale, job satisfaction, and freedom from burnout. The researchers found that higher scores on access to care, communication with patients, and quality improvement were associated with better morale and job satisfaction for providers and staff. A higher overall score for patient-centered care was associated with higher staff morale and tended to correlate with higher provider morale and greater job satisfaction; however, it was negatively correlated with provider freedom from burnout.
Overall, the study shows that the patient-centered medical home model may help improve provider and staff morale and job satisfaction. These factors may help in recruiting primary care workers and limiting turnover. It will be important, however, to monitor providers for signs of burnout. For more information, see: http://www.commonwealthfund.org/Innovations/Tools/2012/Jan/Evaluating-Staff-Morale-in-Safety-Net.aspx