Health Services Research & Development

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2017 HSR&D/QUERI National Conference Abstract

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4019 — What are the Implications for Task Sharing between Interprofessional Team Members?

Lead/Presenter: Linda Kim, COIN - Los Angeles
All Authors: Kim LY (VA Quality Scholars Program; VA HSR&D Center for the Study of Healthcare Innovation, Implementation & Policy, Greater Los Angeles Healthcare System) Rose DE (VA HSR&D Center for the Study of Healthcare Innovation, Implementation & Policy, Greater Los Angeles Healthcare System) Soban LM (Cedars-Sinai Health System) Stockdale SE (VA HSR&D Center for the Study of Healthcare Innovation, Implementation & Policy, Greater Los Angeles; Dept of Psychiatry & Biobehavioral Sciences, UCLA) Meredith LS (VA HSR&D Center for the Study of Healthcare Innovation, Implementation & Policy, Greater Los Angeles Healthcare System; RAND Corporation) Edwards ST (Center to Improve Veteran Involvement in Care, VA Portland Health Care System; Section of General Internal Medicine, VA Portland Health Care System) Helfrich CD (Seattle-Denver Center of Innovation for Veteran-Centered and Value-Driven Care; Dept of Health Services, Univ of Washington School of Public Health) Rubenstein LV (VA HSR&D Center for the Study of Healthcare Innovation, Implementation & Policy, Greater Los Angeles Healthcare System; RAND Corporation)

Objectives:
Little is known about the relationship between task sharing among PCMH team members and which, if any of the primary care tasks performed independently by the provider are associated with higher levels of burnout. Therefore, the purpose of this study was to investigate which primary care tasks performed independently by the provider (without reliance on team members), were particularly associated with higher levels of provider burnout.

Methods:
Secondary data analysis of provider survey data from two time periods (waves). Participants included 327 providers across two waves from 23 VA primary care practices in one VA regional network. Multivariable linear regression analyses were conducted to assess for factors significantly associated with provider burnout.

Results:
In adjusted models, provider reports of intervening on patient lifestyle factors and educating patients about disease-specific self-care activities on their own, without reliance on their team, were significantly associated with higher levels of burnout (intervening on lifestyle: b = 3.80, 95% CI = 0.47, 7.14, p = 0.03; educating patients: b = 3.48, 95% CI = 0.24, 6.72, p = 0.04).

Implications:
Performing behavioral counseling tasks without reliance on team members, was associated with higher levels of provider burnout. Expanding the roles of nurses and other healthcare professionals to assume responsibility for these tasks would ease the burden for providers and reduce provider burnout.

Impacts:
Findings from this study may guide implementation of effective strategies aimed at redistribution of primary care tasks from PCPs to other members of the PCMH team, so that all members of the team may contribute meaningfully to the delivery of coordinated, high-quality, patient-centered care.