当前位置： SCI文献检索 > HEALTH CARE MANAGEMENT REVIEW期刊下所有文献 > Care guides: an examination of occupational conflict and role relationships in primary care.

Care guides: an examination of occupational conflict and role relationships in primary care.

Abstract：

BACKGROUND:Improving the efficiency and effectiveness of primary care treatment of patients with chronic illness is an important goal in reforming the U.S. health care system. Reducing occupational conflicts and creating interdependent primary care teams is crucial for the effective functioning of new models being developed to reorganize chronic care. Occupational conflict, role interdependence, and resistance to change in a proof-of-concept pilot test of one such model that uses a new kind of employee in the primary care office, a "care guide," were analyzed. Care guides are lay individuals who help chronic disease patients and their providers achieve standard health goals. PURPOSE:The aim of this study was to examine the development of occupational boundaries, interdependence of care guides and primary care team members, and acceptance by clinic employees of this new kind of health worker. METHODOLOGY/APPROACH:A mixed methods, pilot study was conducted using qualitative analysis; clinic, provider, and patient surveys; administrative data; and multivariate analysis. Qualitative analysis examined the emergence of the care guide role. Administrative data and surveys were used to examine patterns of interdependence between care guides, physicians, team members, and clinic staff; obtain physician evaluations of the care guide role; and evaluate the effect of care guides on patient perceptions of care coordination and follow-up. FINDINGS:Evaluation of implementation of the care guide model showed that (a) the care guide scope of practice was clearly defined; (b) interdependent relationships between care guides and providers were formed; (c) relational triads consisting of patient, care guide, and physician were created; (d) patients and providers were supported in managing chronic disease; and (e) resistance to this model among traditional employees was minimized. PRACTICE IMPLICATIONS:The feasibility of implementing a new care model for chronic disease management in the primary care setting, identifying factors associated with a positive organizational experience, was shown in this study.

journal_name

Health Care Manage Rev

journal_title

Health care management review

authors

Wholey DR,White KM,Adair R,Christianson JB,Lee S,Elumba D

doi

10.1097/HMR.0b013e31825f3df9

subject

Has Abstract

pub_date

2013-10-01 00:00:00

pages

272-83

issue

eissn

0361-6274

issn

1550-5030

journal_volume

pub_type

杂志文章

在线工具

Care guides: an examination of occupational conflict and role relationships in primary care.