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Measuring Staff Morale in Safety Net Medical Home Adoption



The Patient-Centered Medical Home (PCMH) is a model of comprehensive primary care delivery that studies show can improve the quality and efficiency of care and reduce disparities. PCMH could be particularly valuable in safety net clinics, which provide primary care for over 18 million medically underserved patients. However, the effect on provider and staff morale is unclear. By improving care delivery, the PCMH could create an environment that increases provider and staff job satisfaction. However, implementing the PCMH places extra burdens on providers and staff, especially in safety net clinics, where turnover is often high, so understanding the impact on providers and staff is essential.

With Commonwealth Fund support, Sarah Lewis, M.S.P.H., of the University of North Carolina at Chapel Hill and colleagues at the University of Chicago have developed a survey and scoring algorithm for provider and staff experience specific to the safety net, which complements the previously developed Safety Net Medical Home Scale.

The Issue

Little is known about how provider and staff morale, job satisfaction, and burnout are associated with PCMH adoption in the safety net. Provider and staff experience surveys tailored to safety net clinics will help fill a gap in PCMH evaluation. Understanding the relationship between PCMH adoption and morale, satisfaction, and burnout can provide valuable information to policymakers and administrators responsible for funding and supporting PCMH implementation. 

Target Audience

Patient-centered medical home evaluators, policymakers, and practice administrators

The Intervention

With input from a national advisory committee, investigators at the Commonwealth Fund and the University of Chicago developed the Provider and Staff Experience Surveys and scoring algorithm. The surveys were designed to assess provider and staff experience and perception of their practice’s ability to function as a PCMH. The surveys included new questions and questions adapted from previous health care provider surveys from the Harvard School of Public Health, the Agency for Healthcare Research and Quality (AHRQ), TransforMED, Group Health Cooperative, and Texas Tech University Health Sciences Center.

The surveys were distributed in 2010 to participants in the Fund-supported Safety Net Medical Home Initiative, a five-year demonstration project designed to help 65 community health centers in five states transform into patient-centered medical homes.

The surveys’ results were used to create the scoring algorithm for the both provider and staff surveys, which score on five domains: access to care and communication with patients, communication with other providers, tracking data, care management, and quality improvement.

The scoring algorithm and surveys are available for downloading.

For More Information

See "Patient-Centered Medical Home Characteristics and Staff Morale in Safety-Net Clinics" in the January 9, 2012, issue of Archives of Internal Medicine.

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