Article Figures & Data
Figures
Tables
Supplemental Appendixes 1-4
Supplemental Appendix 1: Design Elements of the Rhode Island and Colorado PCMH Pilots; Supplemental Appendix 2. Key Elements of Rhode Island PCMH Pilot Activities; Supplemental Appendix 3: Survey of Practice Environment and Satisfaction in PCMH Pilots; Supplemental Appendix 4: Interviews With PCMH Practice Leaders at Baseline, 18 Months and 30 Months
Files in this Data Supplement:
- Supplemental data: Appendixes 1-4 - PDF version
In Brief
Practice Environments and Job Satisfaction in Patient-Centered Medical Homes
Shehnaz Alidina , and colleagues
Background The medical home is a patient-centered, team-based model for organizing and delivering primary care. This study evaluates how transforming primary care practices to medical homes affects job satisfaction for clinicians and staff.
What This Study Found 20 primary care practices participating in medical home projects in Rhode Island and Colorado had only inconsistent changes in job satisfaction in the 30 months after the changes were implemented. Job satisfaction improved in Rhode Island but not in Colorado. For both projects, difficulties in providing safe, high-quality care decreased during the study period, but emphasis on quality and the level of chaos did not change significantly. Fewer difficulties in providing safe, high-quality care and more open communication were associated with greater job satisfaction; in contrast, greater office chaos and an emphasis on electronic information were associated with greater stress and burnout.
Implications
- The authors suggest that, in light of the modest and variable impact of medical home intervention on clinician satisfaction, benefits of intervention may be opposed by the stresses of transformation.
- Interventions that reduce difficulties in providing safe, high-quality care without increasing office chaos may offer the best chance of improving job satisfaction.