The authors assessed the effectiveness of Primary Care 2.0, a team-based model that includes an increase in the medical assistant-to-primary care physician ratio; advanced practice provider integration; expanded medical assistants’ roles; and utilization of an extended interprofessional team to support medical assistants. Researchers conducted a prospective, quasi-experimental evaluation of staff and clinician team development and wellness survey data, comparing the program to conventional clinics within Stanford Healthcare. They surveyed staff and clinicians prior to model launch and again at nine, 15- and 24-month intervals post-launch. The team also assessed secondary data, including cost, quality metrics and patient satisfaction via routinely collected operational data. Results indicated that team development significantly increased in the Primary Care 2.0 clinic and was sustained across all three post-implementation intervals. Among the wellness domains, only “control of work” approached significant gains but was not sustained. Burnout showed early trends towards improvement post-implementation but never reached statistical significance and the trend was not sustained over 24 months. Adjusted models confirmed an inverse relationship between team development and burnout. Secondary outcomes, which included cost, quality and patient satisfaction, generally remained stable between intervention and comparison clinics, with labor costs decreasing over the four fiscal years post-launch. The Primary Care 2.0 model of enhanced team-based primary care demonstrates a path to increased team development, which could play a role in protecting health care professionals against burnout, but is not sufficient in preventing it.
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Primary Care 2.0: A Prospective Evaluation of a Novel Model of Advanced Team Care With Expanded Medical Assistant Support
Jonathan G. Shaw, MD, MS, et al
Stanford University School of Medicine, Evaluation Sciences Unit, Division of Primary Care & Population Health, Stanford, California
https://www.annfammed.org/content/19/5/411
The Annals of Family Medicine