an introduction to the national institute for medical assistant advancement
TRANSCRIPT
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PLEASE STAND BYThe webinar will begin shortly
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Get the Most Out of Your Zoom Experience
Send in your questions using the Q&A function in Zoom
Presentation video and slides will be available after on our website: nimaa1.org
Answers to all questions will be posted to the NIMAA website
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Welcome
Mark MasselliPresident and CEOCommunity Health Center, Inc.Connecticut
Board Chair, NIMAA
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Team-Based Care Model The Curriculum Host Clinics Role of Preceptors A Students Perspective Strategic Steps
What We Will Cover
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Ed Wagner, MD, MPH MacColl CenterWashington
Tom Bodenheimer, MD, MPH UCSF School of MedicineCalifornia
Why does NIMAA Matter?
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Tom Bodenheimer, MDCenter for Excellence in Primary CareUniversity of California, San Francisco
Well-trained MAs are essential for
primary care teams
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Competence
• I want my physician to have the knowledge needed to help me
Empathy
• I want my physician to care about me
Familiarity
• I want to know my physician; I want my physician to know me
Continuity
• I want to see my personal physician when I need help
It doesn’t have to be a physician. It could be a NP, PA, RN, behaviorist, pharmacist, physical therapist, or medical assistant.
What do patients want from physicians?Detsky AS, JAMA 2011;306:2500; Safran DG, Ann Intern Med 2003;138:248
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Stable team structure: teamlets
Patientpanel
1 team, 3 teamlets
Clinician + MAteamlet
Patientpanel
Clinician + MAteamlet
Patientpanel
Clinician + MAteamlet
RN, behavioral health professional, social worker, pharmacist, complex care manager
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Definition: stable team/teamlets
1• The same people always work together
2
• Patients empaneled to a teamlet are always cared for by that teamlet
3
• The teamlet is responsible for the health of its patient panel and only sees patients on its panel
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Why should teams be stable?
1• Patients: “I want to know the people caring for me”
and “I want the people caring for me to know me”
2
• Clinicians working with the same MA every day tend to have lower levels of burnout than clinicians working with different people on different days [Willard- Grace et al, J Am Board Fam Med 2014;27:229].
3
• Research shows that patients prefer small practices. A stable team/teamlet divides a large, impersonal practice into small, comfortable units that feel like small practices [Rubin et al, JAMA 1993;270:835].
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Patientpanel
Clinician + MAteamlet
Patientpanel
Clinician + MAteamlet
Patientpanel
Clinician + MAteamlet
Panel management and health coaching
MAs taking responsibilityfor panels of patients
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Sharing the care with MAs:Panel Management
• Preventive care: immunizations, cancer screening (cervical, breast, colorectal)
• Chronic care: e.g. diabetes: all lab tests are done in a timely fashion
Medical assistants identify patients overdue for routine services and arrange for those services to be performed
Physician-written standing orders are needed to empower the medical assistants
Quality of preventive services improves [Chen and Bodenheimer, Arch Intern Med 2011;171:1558]
An estimated 50% of all preventive care activities could be performed by medical assistants [Altschuler et al, Ann Fam Med 2012;10:396-400]
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Sharing the care with MAs:Health Coaching
Health coaching: assisting patients develop the knowledge, skills and confidence to become informed, active participants in their care [Ghorob, Family Practice Management, May/June 2013]
In RCT, patients with MA health coaches had significant drop in A1c and LDL-cholesterol compared with controls [Willard-Grace et al, Ann Fam Med 2015;13:130]
Estimated 25-30% of chronic care activities could be performed by MA health coaches [Altschuler et al, Annals of Family Medicine 2012;10:396]
For health coaching curriculum and 4 videos, see the Center for Excellence in Primary Care website, cepc.ucsf.edu, Tools for Transformation, Health Coaching
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Primary Care Team
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Team Structure:Major Findings from Site Visits
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MA Involvement inKey Functions or Competencies
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http://www.improvingprimarycare.org
Improving Primary Care
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Mary Blankson, DNP, APRN, FNPChief Nursing OfficerCommunity Health Center, Inc.
Mark Splaine, MD, MSEducation DirectorWeitzman Institute
The Curriculum
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Traditional ContentMedical career workforce skillsHealth, disease processes, and preventionPractice in a community health centerCore skills & Externship
NIMAA-specific ContentThe health system and communityTeam-based care (health coaching, panel mgmt)Quality improvementDeveloping as a professionalNIMAA skills
What is the content?
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National CurriculumEveryone does same online workExperience at sites is also coordinated
Site-based LearningLearning specific skillsParticipating in clinic setting from Day 1Close work with preceptors and mentors
How does the curriculum work?
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NIMAA ParticipantIncremental learning with hands-on clinical
application Socialization to the MA role on the care teamExplore possibilities for academic progression
What is the impact?
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Host Clinic SiteOpportunity for existing staff to solidify
commitment to train the next generationEnhances current QI activityEnhances current staff development
programming
What is the impact?
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NationallyCreates a knowledge network between centersPromotes a new standard for MA educationEnhances the interprofessional collaborative
practice team
What is the impact?
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Tillman Farley, MDChief Medical Officer Salud Family Health Center
Teri Brogdon, M.Ed.Education and Training Design DirectorSalud Family Health Center
The Role of the Host Site
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Train students to your center Hire students that you knowReduce training costsIncrease efficiencyImprove care to your patientsImprove the health of your community
What are the benefits for a host site?
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Commitment to the PCMH team-based healthcare delivery model
Recruit and select students Identify staff to be trained as preceptors Support the training model Communicate with NIMAA Help graduating students find a job
In the communities you serve!
Key Expectations of Host Site
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Skills based learning
– students are helpful from day 1 Students are assigned a weekly skill to practice Students are not assigned to an individual MA Every skill is taught, then repeated until
mastery No lost opportunities for practice
NIMAA Additive Skills Training Model
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Productive
Effective
Limited
Graduation
Orientation
NIMAA Additive Skills Model
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Provide curriculum and content Provide on-line training Playbook to guide the host clinic Preceptor trainings and support Technical assistance
NIMAA Role in Supporting The Host Clinic
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Recruitment of students Identifying a NIMAA liaison/Site directorReleasing preceptor time for trainingInvolvement in skills training each weekProviding evaluations and feedback to NIMAAHelping students find a job after graduation
What are the costs for a host site?
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NIMAA host clinics transform health care, one MA at a time!
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Natasha Quinn Senior Medical AssistantCommunity Health Center, Inc.
The Role of Preceptors
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Role of the Preceptor
Training NIMAA Participants
Benefits of being a Preceptor
The Role of the Preceptor
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Jenn DepreyNIMAA’s Pioneer ClassCommunity Health Center, Inc.
A Participant’s Perspective
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Differences between NIMAA and standard MA education models
NIMAA provides a better way of learning
Working in Team-Based Care
A Participant’s Perspective
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David AylwardNIMAA Project Lead
What’s Next?
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Characteristics of a NIMAA Host Clinic: Strong support and involvement of top leadership Share NIMAA’s dual goals: better care through trained workforce; better student
careers Implementing model of care where MAs are becoming key members of the PCMH
team
NIMAA Provides to Host Clinics: Experienced faculty and Instructional staff: regular live, taped lectures and discussions Complete online curriculum and program with textbooks, supporting IT systems Preceptor training program, with guidance for teaching and measuring specific
traditional and PCMH skills; available to all staff during Phase II Support for host clinic leader and preceptors Manage all enrollment, grading, certification and grievance issues.
Phase II “Get”
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Responsibilities of a NIMAA Host Clinic: Interview, help select, host MA candidates for the 7 month training
session Appoint a NIMAA program leader Select qualified preceptor for each medical assistant candidate Host candidates 4 hours daily as they assist a care team and learn
from preceptors Organize weekly coordination and feedback meeting for candidates Support NIMAA in obtaining state teaching licensure Provide feedback Pay tuition
Phase II “Give”
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Survey for all of you What are your pain points? Interests in workforce development?
NIMAA Host clinic for full Phase II program (9/17) Host clinic for full Phase III program (4/18) Contributor to program content Upskill existing staff: apprentice programs
Other workforce development/transformation training
Next Steps Pathways
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February: Fill out survey February: Conversations Early March: Virtual workshop April and May: Selection of Phase II partners June and July: Recruit and qualify students Summer: Host clinic selects, NIMAA trains site lead
and preceptors July and August: Select students September: Training begins
NIMAA Full Program Phase II
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Any Questions?