To discuss the role of hospital workforces in redesigning primary care delivery, the American Hospital Association conducted a roundtable in September 2011 made up of nine physician and nurse leaders. They were tasked with establishing recommendations for hospitals and health systems to plan workforce strategies to meet primary care demands.
The roundtable came up with the following recommendations, specific to hospitals' workforces and primary care delivery models.
Workforce
1. All healthcare professionals should be educated within the context of interdisciplinary, clinical learning teams. Clinical education systems should include curricula supportive of interdisciplinary and team-based learning, according to the roundtable. Providers should transition from task-based to role-based work. This will help prepare a workforce for clinical integration and multidisciplinary care teams, but the re-education of current workforce members under these collaborative principles may prove to be an even greater challenge.
Primary care delivery model
1. Primary healthcare should be patient- and family-centered with user-driven design. This is the core recommendation from the roundtable and, "without it, all other recommendations for redesign may not be sustainable," according to the white paper.
2. Hospitals should move away from traditional "hospitals" to "health systems" by partnering with community organizations and patients. Without links to the local community, hospitals' pursuits to evolve into centers of wellness will not be effective. Hospitals should form collaborative ties with community entities to create personalized healthcare options for patients.
3. Hospitals and health systems can lead the integration of various components of health and wellness. By linking primary care services, hospitals can provide a sustainable infrastructure for patients and the communities. This includes team members who connect patients with community health resources, such as health coaches or healthcare navigators. "There is compelling data that shows these new team members can have a positive impact on adherence to treatment plans … contribute to better outcomes and help lower costs," according to the white paper.
4. Hospital should begin the shift to quality-based reimbursement. "This means patients and organizations alike will need to transition from the episodic, fee-for-service model of reimbursement to a new model that will reimburse for and encourage wellness," according to the white paper. The roundtable also noted that this change will require "significant legislative and reimbursement reform."
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The roundtable came up with the following recommendations, specific to hospitals' workforces and primary care delivery models.
Workforce
1. All healthcare professionals should be educated within the context of interdisciplinary, clinical learning teams. Clinical education systems should include curricula supportive of interdisciplinary and team-based learning, according to the roundtable. Providers should transition from task-based to role-based work. This will help prepare a workforce for clinical integration and multidisciplinary care teams, but the re-education of current workforce members under these collaborative principles may prove to be an even greater challenge.
Primary care delivery model
1. Primary healthcare should be patient- and family-centered with user-driven design. This is the core recommendation from the roundtable and, "without it, all other recommendations for redesign may not be sustainable," according to the white paper.
2. Hospitals should move away from traditional "hospitals" to "health systems" by partnering with community organizations and patients. Without links to the local community, hospitals' pursuits to evolve into centers of wellness will not be effective. Hospitals should form collaborative ties with community entities to create personalized healthcare options for patients.
3. Hospitals and health systems can lead the integration of various components of health and wellness. By linking primary care services, hospitals can provide a sustainable infrastructure for patients and the communities. This includes team members who connect patients with community health resources, such as health coaches or healthcare navigators. "There is compelling data that shows these new team members can have a positive impact on adherence to treatment plans … contribute to better outcomes and help lower costs," according to the white paper.
4. Hospital should begin the shift to quality-based reimbursement. "This means patients and organizations alike will need to transition from the episodic, fee-for-service model of reimbursement to a new model that will reimburse for and encourage wellness," according to the white paper. The roundtable also noted that this change will require "significant legislative and reimbursement reform."
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