PubMed · 2089303
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M McLaughlin. Training for support workers.. https://pubmed.ncbi.nlm.nih.gov/2089303/
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In the current health care environment, buzzwords such as redesign, reengineering, restructuring, right-sizing, customer service, diversity, quality, multiskilled workers, and unlicensed assistive personnel conjure up many notions about how perioperative nurses can meet the needs and wants of their patients. Unlicensed assistive personnel are becoming commonplace in our hospitals and have assumed a variety of positions and functions. This article describes a project that one hospital undertook to create unlicensed, multiskilled workers in the perioperative area.
The recent and profound changes in the American health care delivery system have created a need for physicians who are trained and willing to assume a high level of responsibility for managing evolving health care organizations. Yet most physicians receive no formal training in medical administration and management because changes in medical school and residency education have lagged behind changes in clinical practice and reimbursement. To avoid haphazard approaches and unnecessary duplication of resources, it is important for physicians involved in managerial medicine to collectively identify competencies in this area needed in the marketplace. The American College of Preventive Medicine (ACPM), with funding from the Health Resources and Services Administration (HRSA), undertook an effort to identify competencies essential for physicians who will fill leadership roles in medical management. Like ACPM's earlier effort to develop core competencies in preventive medicine, this project drew upon the theoretical model of competency-based education. This article describes the strategy we followed in reaching consensus among a diverse group of physician executives and preventive medicine residency program directors, and includes the list of medical management competencies and performance indicators developed. Recurrent issues that can sidetrack competency development projects are also presented as well as suggestions for overcoming them. The competencies can serve as a framework for expanding current core preventive medicine training in management and administration and for developing new training programs to equip physicians with the special expertise they will need to provide management leadership within the changing landscape of health care delivery.
Many of the traditional approaches to providing continuing medical education (CME) have failed to improve physician performance and health care outcomes. In the current health care environment, physicians are being held to unprecedented levels of accountability to patients, payers, and society at large. A greater emphasis is being placed on measuring and improving the clinical and fiscal outcomes of medical care. If they are to help physicians practice more effectively and efficiently, CME developers must reformulate the missions and goals of their programs. CME must become a means for improving patient outcomes through enhanced physician performance. The author describes how a new practice-learning model for CME might be implemented using currently available information technology. She also discusses how CME programs, with the help of information technology, can help physicians identify learning opportunities, find the best resources for learning, and apply learning to practice. She then briefly discusses three programs that have begun to utilize information technology to expand the scope of CME: the Maintenance of Competence Program in Canada, the Stanford Health Information Network for Education, and a computer-simulation program at the Indiana University School of Medicine.