Association of Burnout With Primary Care Clinician Perception of Team-Based Scheduling Support.

INTRODUCTION: Primary care clinician burnout is pervasive and detrimental. How components of teamwork and clinic culture might contribute to burnout remains unsettled. OBJECTIVE: To examine associations between primary care clinician perceptions of specific components of teamwork and of organizational culture, and perceived stress and burnout. METHODS: Cross-sectional survey study of primary care clinicians from 5 county health system clinics. Measures: Perceptions of teamwork related to coordination of care, and clinic provision of chronic disease self-management support; values alignment and workplace equity; and demographics. DATA ANALYSIS: Descriptive statistics and Spearman's correlations to examine associations, controlling for clinic and examining response variability by clinic. RESULTS: Of 72 clinicians, 64% were female and 32% non-white. About 56% had worked at least 4 years and half worked 5 to 6 half days/week or more in their clinic. Clinicians who reported having someone on the clinician's care team routinely schedule follow-up appointments for patients with complex chronic illnesses reported lower stress and burnout. Those who perceived greater values alignment with their clinic and greater personal and employee equitable treatment had lower stress and burnout. CONCLUSIONS: Teamwork among clinicians and non-clinical staff, a component of teamwork that is not well-considered in current literature, could be an important piece of the puzzle to decrease the persistent and challenging issue of stress and burnout among primary care clinicians.

How Comprehensive Medication Management Contributes to Foundational Elements of Primary Care.

Pharmacists are more often being recognized as a critical component of the primary care team. Previous literature has not clearly made the connection to how pharmacists and comprehensive medication management (CMM) contribute to recognized foundational elements of primary care. In this reflection, we examine how the delivery of CMM both supports and aligns with Starfield's 4 Cs of Primary Care. We illustrate how the delivery of CMM supports first contact through increased provider access, continuity through empanelment, comprehensiveness by addressing unmet medication needs, and coordination through collaborating with the primary care team and broader team. The provision of CMM addresses critical unmet medication-related needs in primary care and is aligned with the foundational elements of primary care.

Primary Care Providers Believe That Comprehensive Medication Management Improves Their Work-Life.

PURPOSE: In primary care, clinical pharmacists often deliver a service called comprehensive medication management (CMM). While research has identified that CMM positively influences most aspects of the Quadruple Aim, it is unclear how CMM-both the service and the role of the pharmacist-may influence the primary care provider's (PCP) clinical work, professional satisfaction, and burnout (described here as PCP's work-life). We aimed to identify how PCPs perceive CMM impacts their work-life. METHODS: Sixteen PCPs were interviewed. Interview questions centered on how CMM affects their work-life. After interviews were transcribed, a codebook was developed by 2 researchers and from the codes, themes were identified. RESULTS: PCPs spoke of the pharmacist being an added skillset and resource and a collaborative partner in caring for patients. They also described 7 outcomes of having CMM available that contribute to their work-life. These outcomes were: decreased workload, satisfaction patients are receiving better care, reassurance, decreased mental exhaustion, enhanced professional learning, increased provider access, and achievement of quality measures. Lastly, the PCPs described barriers and areas of opportunity related to CMM. CONCLUSION: Our findings suggest PCPs believe CMM, in general, positively affects their work-life. CMM's impact on PCPs aligns with many previously identified drivers of burnout and engagement among providers. These results shed light on how CMM may foster achievement of the Quadruple Aim.

Team work and collaborative practice agreements among pharmacists and nurse practitioners.

OBJECTIVES: The authors share their knowledge about partnering and establishing collaborative practice agreements with nurse practitioners. State laws and regulations were reviewed that affect pharmacists' ability to fully partner with nurse practitioners. SUMMARY: Nurse practitioners' role in primary care is growing, and, in many states, nurse practitioners practice independently. Collaborative practice agreements (CPAs) enable pharmacists to work with prescribers more efficiently. Pharmacists' and nurse practitioners' scope-of-practice laws and regulations may prevent CPAs between pharmacists and nurse practitioners. State pharmacy practice acts were reviewed to demonstrate which states allow for partnership under a CPA. CONCLUSION: Pharmacists should consider opportunities to partner more closely with nurse practitioners to provide care, sometimes under a CPA. In states where laws or regulations prevent CPAs between pharmacists and nurse practitioners, pharmacists should advocate for policy change.