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An Introduction to the National Institute for Medical Assistant Advancement

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View the slides from NIMAA's Webinar about a groundbreaking new way to train key primary care team members featuring national leaders, including:
Thomas Bodenheimer, MD, MPH, UCSF School of Medicine, California
Edward Wagner, MD, MPH, MacColl Center, Washington
Mark Masselli, CEO, Community Health Center, Inc; Chairman, NIMAA

Published in: Healthcare
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An Introduction to the National Institute for Medical Assistant Advancement

  1. 1. PLEASE STAND BY The webinar will begin shortly
  2. 2. Get the Most Out of Your Zoom Experience  Send in your questions using the Q&A function in Zoom  Presentation video and slides will be available after on our website: nimaa1.org  Answers to all questions will be posted to the NIMAA website
  3. 3. Welcome Mark Masselli President and CEO Community Health Center, Inc. Connecticut Board Chair, NIMAA
  4. 4. Team-Based Care Model The Curriculum Host Clinics Role of Preceptors A Students Perspective Strategic Steps What We Will Cover
  5. 5. Ed Wagner, MD, MPH MacColl Center Washington Tom Bodenheimer, MD, MPH UCSF School of Medicine California Why does NIMAA Matter?
  6. 6. Tom Bodenheimer, MD Center for Excellence in Primary Care University of California, San Francisco Well-trained MAs are essential for primary care teams
  7. 7. Competence • I want my physician to have the knowledge needed to help me Empathy • I want my physician to care about me Familiarity • I want to know my physician; I want my physician to know me Continuity • I want to see my personal physician when I need help It doesn’t have to be a physician. It could be a NP, PA, RN, behaviorist, pharmacist, physical therapist, or medical assistant. What do patients want from physicians? Detsky AS, JAMA 2011;306:2500; Safran DG, Ann Intern Med 2003;138:248
  8. 8. Stable team structure: teamlets Patient panel 1 team, 3 teamlets Clinician + MA teamlet Patient panel Clinician + MA teamlet Patient panel Clinician + MA teamlet RN, behavioral health professional, social worker, pharmacist, complex care manager
  9. 9. Definition: stable team/teamlets 1 • The same people always work together 2 • Patients empaneled to a teamlet are always cared for by that teamlet 3 • The teamlet is responsible for the health of its patient panel and only sees patients on its panel
  10. 10. Why should teams be stable? 1 • Patients: “I want to know the people caring for me” and “I want the people caring for me to know me” 2 • Clinicians working with the same MA every day tend to have lower levels of burnout than clinicians working with different people on different days [Willard- Grace et al, J Am Board Fam Med 2014;27:229]. 3 • Research shows that patients prefer small practices. A stable team/teamlet divides a large, impersonal practice into small, comfortable units that feel like small practices [Rubin et al, JAMA 1993;270:835].
  11. 11. Patient panel Clinician + MA teamlet Patient panel Clinician + MA teamlet Patient panel Clinician + MA teamlet Panel management and health coaching MAs taking responsibility for panels of patients
  12. 12. Sharing the care with MAs: Panel Management •Preventive care: immunizations, cancer screening (cervical, breast, colorectal) •Chronic care: e.g. diabetes: all lab tests are done in a timely fashion Medical assistants identify patients overdue for routine services and arrange for those services to be performed Physician-written standing orders are needed to empower the medical assistants Quality of preventive services improves [Chen and Bodenheimer, Arch Intern Med 2011;171:1558] An estimated 50% of all preventive care activities could be performed by medical assistants [Altschuler et al, Ann Fam Med 2012;10:396-400]
  13. 13. Sharing the care with MAs: Health Coaching Health coaching: assisting patients develop the knowledge, skills and confidence to become informed, active participants in their care [Ghorob, Family Practice Management, May/June 2013] In RCT, patients with MA health coaches had significant drop in A1c and LDL- cholesterol compared with controls [Willard-Grace et al, Ann Fam Med 2015;13:130] Estimated 25-30% of chronic care activities could be performed by MA health coaches [Altschuler et al, Annals of Family Medicine 2012;10:396] For health coaching curriculum and 4 videos, see the Center for Excellence in Primary Care website, cepc.ucsf.edu, Tools for Transformation, Health Coaching
  14. 14. Primary Care Team
  15. 15. Team Structure: Major Findings from Site Visits
  16. 16. MA Involvement in Key Functions or Competencies
  17. 17. http://www.improvingprimarycare.org Improving Primary Care
  18. 18. Mary Blankson, DNP, APRN, FNP Chief Nursing Officer Community Health Center, Inc. Mark Splaine, MD, MS Education Director Weitzman Institute The Curriculum
  19. 19. Traditional Content Medical career workforce skills Health, disease processes, and prevention Practice in a community health center Core skills & Externship NIMAA-specific Content The health system and community Team-based care (health coaching, panel mgmt) Quality improvement Developing as a professional NIMAA skills What is the content?
  20. 20. National Curriculum Everyone does same online work Experience at sites is also coordinated Site-based Learning Learning specific skills Participating in clinic setting from Day 1 Close work with preceptors and mentors How does the curriculum work?
  21. 21. NIMAA Participant Incremental learning with hands-on clinical application Socialization to the MA role on the care team Explore possibilities for academic progression What is the impact?
  22. 22. Host Clinic Site Opportunity for existing staff to solidify commitment to train the next generation Enhances current QI activity Enhances current staff development programming What is the impact?
  23. 23. Nationally Creates a knowledge network between centers Promotes a new standard for MA education Enhances the interprofessional collaborative practice team What is the impact?
  24. 24. Tillman Farley, MD Chief Medical Officer Salud Family Health Center Teri Brogdon, M.Ed. Education and Training Design Director Salud Family Health Center The Role of the Host Site
  25. 25. Train students to your center Hire students that you know Reduce training costs Increase efficiency Improve care to your patients Improve the health of your community What are the benefits for a host site?
  26. 26.  Commitment to the PCMH team-based healthcare delivery model  Recruit and select students  Identify staff to be trained as preceptors  Support the training model  Communicate with NIMAA  Help graduating students find a job In the communities you serve! Key Expectations of Host Site
  27. 27.  Skills based learning – students are helpful from day 1  Students are assigned a weekly skill to practice  Students are not assigned to an individual MA  Every skill is taught, then repeated until mastery  No lost opportunities for practice NIMAA Additive Skills Training Model
  28. 28. Productive Effective Limited Graduation Orientation NIMAA Additive Skills Model
  29. 29.  Provide curriculum and content  Provide on-line training  Playbook to guide the host clinic  Preceptor trainings and support  Technical assistance NIMAA Role in Supporting The Host Clinic
  30. 30.  Recruitment of students  Identifying a NIMAA liaison/Site director Releasing preceptor time for training Involvement in skills training each week Providing evaluations and feedback to NIMAA Helping students find a job after graduation What are the costs for a host site?
  31. 31. NIMAA host clinics transform health care, one MA at a time!
  32. 32. Natasha Quinn Senior Medical Assistant Community Health Center, Inc. The Role of Preceptors
  33. 33.  Role of the Preceptor  Training NIMAA Participants  Benefits of being a Preceptor The Role of the Preceptor
  34. 34. Jenn Deprey NIMAA’s Pioneer Class Community Health Center, Inc. A Participant’s Perspective
  35. 35.  Differences between NIMAA and standard MA education models  NIMAA provides a better way of learning  Working in Team-Based Care A Participant’s Perspective
  36. 36. David Aylward NIMAA Project Lead What’s Next?
  37. 37. Characteristics of a NIMAA Host Clinic:  Strong support and involvement of top leadership  Share NIMAA’s dual goals: better care through trained workforce; better student careers  Implementing model of care where MAs are becoming key members of the PCMH team NIMAA Provides to Host Clinics:  Experienced faculty and Instructional staff: regular live, taped lectures and discussions  Complete online curriculum and program with textbooks, supporting IT systems  Preceptor training program, with guidance for teaching and measuring specific traditional and PCMH skills; available to all staff during Phase II  Support for host clinic leader and preceptors  Manage all enrollment, grading, certification and grievance issues. Phase II “Get”
  38. 38. Responsibilities of a NIMAA Host Clinic:  Interview, help select, host MA candidates for the 7 month training session  Appoint a NIMAA program leader  Select qualified preceptor for each medical assistant candidate  Host candidates 4 hours daily as they assist a care team and learn from preceptors  Organize weekly coordination and feedback meeting for candidates  Support NIMAA in obtaining state teaching licensure  Provide feedback  Pay tuition Phase II “Give”
  39. 39. Survey for all of you  What are your pain points? Interests in workforce development? NIMAA  Host clinic for full Phase II program (9/17)  Host clinic for full Phase III program (4/18)  Contributor to program content  Upskill existing staff: apprentice programs Other workforce development/ transformation training Next Steps Pathways
  40. 40.  February: Fill out survey  February: Conversations  Early March: Virtual workshop  April and May: Selection of Phase II partners  June and July: Recruit and qualify students  Summer: Host clinic selects, NIMAA trains site lead and preceptors  July and August: Select students  September: Training begins NIMAA Full Program Phase II
  41. 41. Any Questions?
  42. 42. Contact us: nimaa@chc1.com www.nimaa1.org Thank you for attending!

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