Journal article
The empowerment paradox as a central challenge to patient centered medical home implementation in the veteran's health administration
Journal of interprofessional care, Vol.29(1), pp.26-33
01/02/2015
DOI: 10.3109/13561820.2014.937480
PMID: 25052920
Abstract
In this paper we present results of a mixed methods study conducted to identify barriers to team function among staff implementing patient aligned care teams - the Department of Veterans Affairs' patient centered medical home (PCMH) model. Using a convergent mixed methods design, we administered a standardized survey measure (Team and Individual Role Perception Survey) to assess work role challenge and engagement; and conducted discussion groups to gather context pertaining to role change. We found that the role of primary care providers is highly challenging and did not become less difficult over the initial year of implementation. Unexpectedly over the course of the first year nurse care managers reported a decrease in their perceptions of empowerment and clerical associates reported less skill variety. Qualitative data suggest that more skilled team members fail to delegate and share tasks within their teams. We characterize this interprofessional knowledge factor as an empowerment paradox where team members find it difficult to share tasks in ways that are counter to traditionally structured hierarchical roles. Health care systems seeking to implement PCMH should dedicate resources to facilitating within-team role knowledge and negotiation.
Details
- Title: Subtitle
- The empowerment paradox as a central challenge to patient centered medical home implementation in the veteran's health administration
- Creators
- Samantha L Solimeo - Department of Veterans Affairs, Center for Comprehensive Access & Delivery Research and EvaluationSarah S Ono - Department of Veterans Affairs, Office of Rural Health - Central RegionMichelle A. M Lampman - Department of Veteran Affairs, VISN 23 Patient Aligned Care Team Demonstration LabMonica B. W Paez - Department of Veterans Affairs, Center for Comprehensive Access & Delivery Research and EvaluationGregory L Stewart - Henry B. Tippie College of Business, University of Iowa
- Resource Type
- Journal article
- Publication Details
- Journal of interprofessional care, Vol.29(1), pp.26-33
- Publisher
- Informa Healthcare
- DOI
- 10.3109/13561820.2014.937480
- PMID
- 25052920
- ISSN
- 1356-1820
- eISSN
- 1469-9567
- Language
- English
- Date published
- 01/02/2015
- Academic Unit
- Management and Entrepreneurship ; General Internal Medicine; Internal Medicine
- Record Identifier
- 9984094340002771
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