Traci H Abraham1,2,3, Greg L Stewart4,5, Samantha L Solimeo4,6,7,8. 1. VA Office of Patient Care Services, Primary Care Analytics Team-Iowa City, Iowa City VA Health Care System, Iowa City, IA, USA. Traci.Abraham@va.gov. 2. Center for Mental Healthcare & Outcomes Research (CeMHOR), Central Arkansas Veterans Healthcare System, 2200 Fort Roots Rd., Bldg 58, North Little Rock, AR, 72114, USA. Traci.Abraham@va.gov. 3. Department of Psychiatry, Center for Health Services Research (CHSR), University of Arkansas for Medical Sciences, Little Rock, AR, USA. Traci.Abraham@va.gov. 4. VA Office of Patient Care Services, Primary Care Analytics Team-Iowa City, Iowa City VA Health Care System, Iowa City, IA, USA. 5. Department of Management & Entrepreneurship, Tippie College of Business, University of Iowa, Iowa City, IA, USA. 6. VA Office of Rural Health, Veterans Rural Health Resource Center- Iowa City, Iowa City VA Health Care System, Iowa City, IA, USA. 7. Center for Access & Delivery Research & Evaluation (CADRE), Iowa City VA Health Care System, Iowa City, IA, USA. 8. Department of General Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA, USA.
Abstract
BACKGROUND: Learning healthcare systems have invested heavily in training primary care staff to provide care using patient-centered medical home models, but less is known about how to effectively lead such teams to deliver high quality care. Research is needed to better understand which healthcare leadership skills are most utilized or in need of development through additional training. METHOD: Semi-structured telephone interviews with healthcare leaders familiar with Patient-Aligned Care Teams (PACT) implementation in the U.S. Department of Veterans Affairs (VA). We interviewed sixteen (N = 16) physician, nursing, and administrative leaders at VA facilities located in the upper Midwestern United States. Content analysis of interviews transcripts using template techniques. RESULTS: Participants described instrumental challenges that they perceived hindered leadership effectiveness, including the supervisory structure; pace of change; complexity of the clinical data infrastructure; an over-reliance on technology for communication; and gaps in available leadership training. Factors perceived as facilitating effective leadership included training in soft skills, face-to-face communication, and opportunities for formal training and mentorship. A cross-cutting theme was the importance of developing "soft skills" for effective PACT leadership. CONCLUSIONS: Although formal leadership training and development were perceived as beneficial, healthcare leaders familiar with PACT implementation in the VA described a mismatch between the skills and knowledge PACT leaders need to succeed and the training available to them. Closing this gap could improve retention of skilled and knowledgeable healthcare leaders, thereby reducing the costs associated with training and leading to improvements in healthcare delivery.
BACKGROUND: Learning healthcare systems have invested heavily in training primary care staff to provide care using patient-centered medical home models, but less is known about how to effectively lead such teams to deliver high quality care. Research is needed to better understand which healthcare leadership skills are most utilized or in need of development through additional training. METHOD: Semi-structured telephone interviews with healthcare leaders familiar with Patient-Aligned Care Teams (PACT) implementation in the U.S. Department of Veterans Affairs (VA). We interviewed sixteen (N = 16) physician, nursing, and administrative leaders at VA facilities located in the upper Midwestern United States. Content analysis of interviews transcripts using template techniques. RESULTS:Participants described instrumental challenges that they perceived hindered leadership effectiveness, including the supervisory structure; pace of change; complexity of the clinical data infrastructure; an over-reliance on technology for communication; and gaps in available leadership training. Factors perceived as facilitating effective leadership included training in soft skills, face-to-face communication, and opportunities for formal training and mentorship. A cross-cutting theme was the importance of developing "soft skills" for effective PACT leadership. CONCLUSIONS: Although formal leadership training and development were perceived as beneficial, healthcare leaders familiar with PACT implementation in the VA described a mismatch between the skills and knowledge PACT leaders need to succeed and the training available to them. Closing this gap could improve retention of skilled and knowledgeable healthcare leaders, thereby reducing the costs associated with training and leading to improvements in healthcare delivery.
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