Job Satisfaction and Information Technology Questionnaire - PowerPoint by qhu43966


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In 2006 both the American Academy of Physician Assistants and the Society of Hospital Medicine published the core competencies
(TCC) in the practice of medicine. There is no published literature on the application of TCC for physician assistants (PAs) and there
may be training gaps just as there are in Hospital Medicine. In their role as teachers, hospitalists can create a greater sense of learning
for PAs on the multidisciplinary care team and promote job satisfaction. Brigham and Women’s Hospital (BWH) in Boston is the
largest employer of PAs in New England with approximately 100 PAs making up the fastest growing population across the institution.
Working with PAs to develop a CME program for PAs is one step hospitalists can take to foster professional development.

Our educational strategy has been to develop a monthly PA educational series for BWH and Dana Farber Cancer Institute (DFCI) PAs,
provide opportunity for PAs to receive CME credits easily on-site, measure educational outcomes, and ultimately to improve patient

Funding for this initiative came from a BWH SEED Grant award, a Health Information/Technology award from the National Network
of Libraries of Medicine New England Region as well as funding from the BWH CMO and DFCI CMO. A needs assessment was
based on review of the literature, surveys of the target audience, PA focus groups, and expert consensus of PA chiefs. The goals and
objectives were written to match real world job performance and to meet identified needs. PAs identified problematic cases that
formed the basis for discussion. All teaching sessions begin with a case presentation by a PA followed by breakout sessions in small
groups at portable computers. Hospitalists and a librarian worked with the PA presenter to facilitate discussion regarding how to write
learning objectives, frame clinical questions, and then use information technology resources including Pubmed, clinical guidelines, and
other electronic sources available through the hospital network.

Developing habits for life-long learning are important ideals for professionals and a multidisciplinary PA Grand Rounds program
which is a departure from passive didactic lectures is one way to effectively address these goals. In addition to evaluation forms
circulated at the conclusion of each session, we are evaluating the impact of our curriculum by using an adapted Fresno Test of
competence in evidence-based medicine and a job satisfaction questionnaire. Key questions remain whether an innovative, PA-centric,
competency-based educational program can change clinical outcomes and improve PA job satisfaction.
Physician Assistant-Hospitalist Curriculum

       Overall, I am satisfied with my job

                 87%        91%
60%                                          Pre

         *Post = Midway through curriculum
Physician Assistant-Hospitalist Curriculum

        My patient load is reasonable

                          84%              Pre
60%            77%

       *Post = Midway through curriculum
Physician Assistant-Hospitalist Curriculum

       I have opportunities to grow and
             advance in my career
60%                        75%
40%             62%


        *Post = Midway through curriculum
Working with PAs, Hospitalists
    should ensure that:

 • PAs can do their jobs smoothly and efficiently
 • The needs of PAs are met
 • PAs have a voice at their institution
        Attitudes or Core Values
Our core values shaped our educational strategy
• PAs are an integral part of hospital practice
• Team learning is professionally rewarding
• We want to facilitate learning for PAs so that they can
  evaluate and improve their patient care practices
Hence, the format of the course is not the traditional
lecture where attendees passively listen to a speaker
• PA centric curriculum based on educational needs
   identified by PAs
• Cases developed by PAs for PAs
Constraints – available time for PAs working different
                                             Growth of PA Service from 2000-2007
Number of PAs at BWH and

                           120                                                     111

                           100                                               91

                           60                       44
                           40      26
                                 prior to   2001    2002    2003    2004    2005   2006   2007
Growth of Hospital Medicine

              Source: Society of Hospital Medicine
       A Work In Progress
Ongoing evaluation like any QI project

       What are we    How will we know     What changes can we
         trying to   that a change is an   make that will result in
       accomplish?     improvement?           improvement?

                     ACT         PLAN

                     STUDY       DO
Transforming Hospital Care:
   Value of Curriculum Development

          Interpersonal and
        Communication Skills
     Practice Based Learning
     Systems Based Practice

       Medical Knowledge
   Dana-Farber Cancer Institute
The mission of Dana-Farber Cancer Institute is to provide expert, compassionate care to
children and adults with cancer while advancing the understanding, diagnosis, treatment,
cure, and prevention of cancer and related diseases. As an affiliate of Harvard Medical
School and a Comprehensive Cancer Center designated by the National Cancer Institute,
the Institute also provides training for new generations of physicians and scientists,
designs programs that promote public health particularly among high-risk and
underserved populations, and disseminates innovative patient therapies and scientific
discoveries to our target community across the United States and throughout the world.

Dana-Farber Cancer Institute's ultimate goal is the eradication of cancer, AIDS, and
related diseases and the fear that they engender.

Core Values
Above all else, we make a difference by relieving the burden of disease now and for the
future through our research, clinical care, education, outreach and advocacy.
     Brigham and Women’s Hospital
As part of the Partners HealthCare System, Brigham and Women’s Hospital (BWH) is dedicated to serving the needs
of the community. It is committed to providing the highest quality health care to patients and their families, to
expanding the boundaries of medicine through research, and to educating the next generation of health care
professionals. Through the Partners HealthCare System, BWH will take a leadership role in the development of an
integrated care network providing a full range of cost-effective, patient centered services.

                         As part of its mission, BWH/Partners will seek to:
Provide high quality and compassionate primary, secondary and tertiary services to patients in the most cost-effective settings possible
within an integrated network.

Improve the health status of the local Boston community through the direct operation of community health service, and the development
of innovative public and school-based health programs

Serve as one of the world’s premier resources for innovative research in biomedicine, health services and clinical epidemiolo gy.

Recruit the highest quality medical students, residents, fellows, nursing students, and other health care professionals and prepare them for
leadership in clinical practice, research, and academic medicine. Address the urgent national need for leaders from the diverse groups that
comprise the American population.

Serve as a national leader in the demonstration and practice of clinical efficiency and continuous quality improvement.
Provide all employees with appropriate working conditions and opportunities to achieve their full potential as individuals and as members
of the BWH health care team.

Manage and use information, through the most technologically advanced systems available, to enhance and improve patient care, doing so
in a way that will protect confidentiality.

Develop and implement biotechnologies which will improve patients’ care and reduce costs.
                 Funding Opportunities
1. SEED Grant – 6K
    –   BWH Department of Medicine
2. Regional Medical Library Grant for PAs – 10K
    –   Preparing for submission
3. BWH, CMO Funding – 5K
    –   Approved in FY07 Budget
4. DFCI, CMO Funding – 1.5K
    –   Support Offered By Drs Shulman and Alyea

            Implement Curricula and Training Activities
        Laptop including Accessories                        $ 1,700.
                      Projector                             $ 1,350.
                Materials – Books                           $ 5,100.
                       Printing                             $ 2,000.

                         Total                              $ 10,150
Learner’s achievement of each
1. The learner will be able to explain how to
   present a case study and how to frame specific
   questions relevant to a case.
2. The learner will be able to describe different
   methods for conducting literature searches to
   suppose clinical decision making and practice
   based learning.
3. The learner will be able to take advantage of
   resources within Partners and on the web
   relevant to the case discussion.
                Next Steps:
  Like hospitalists, the role of PAs are
        changing and increasing

Hospitalists can:
•    Play a key role in working with PAs to develop a
     centric competency based curriculum
•    Work with PAs to create a professional PA model
     consistent with other professional clinical groups
•    Involve them in teaching activities, quality
     improvement and risk management.

•   More work is needed to determine impact on
    clinical outcomes.
•   Preliminary data positive relating to job
•   The role of the hospitalist as teacher and
    learner as a member of multidisciplinary team
    is important for job satisfaction for both
    hospitalist and PAs.

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