Objectives • Identify methods to enhance medical assistant top of education practice, using a phased orientation pathway. • Discuss the benefits of a medical assistant orientation pathway on staff engagement, clinic satisfaction, and MA retention.
Background: In 2019, our organization started the journey to ensure all clinical team members were working at the top of their education and skill set. Utilizing our ambulatory care shared governance platform, an assessment of registered nurse (RN) tasks was completed and categorized. Each task fell into three categories: 1) RN-only task (cannot be delegated), 2) RN or medical assistant (MA) task (depending on setting and skill set), and 3) non-RN task (does not require RN skill set). We also assessed current MA staff to determine appropriate skill sets and competencies.
Based on our assessment, it was determined that certain tasks could be removed from the RN workflow and added to clinic MA practice to support top of practice work in both roles. However, a gap was noted in MA confidence, critical thinking, and skill set to successfully complete certain tasks.
Description of project: To meet the goal of increasing MA confidence, skills, and critical thinking, a new phased orientation pathway was developed. The pathway includes orientation to clinic workflow and point of care testing, education on specific clinic diagnoses, opportunities to enhance provider interaction and support, and activities promoting care coordination. Each phase of the pathway consists of shadow opportunities, critical-thinking worksheets, and provider interactions to assist the MA in understanding the complex needs of their patient populations and support interdisciplinary communication. In the final phase, MAs utilize the learned knowledge from worksheets, clinical experiences and practice, and observation/shadow experiences to complete a diagnosis concept map for each identified diagnosis, bringing together the full patient picture. The orientation pathway and tools are integrated into our shared electronic platform (electronic orientation binder) to increase ease of use and monitor ongoing progress. Utilizing change management strategies, our program has been met with minimal resistance.
Results: Preliminary post-implementation results show increased MA and provider satisfaction, decreased MA turnover, improved clinic workflows and productivity, and improved interdisciplinary communication. Additionally, a significant percent of MA turnover was due to career and professional growth within the organization, as a result of enhanced critical thinking and role changes related to this program.
Conclusion/future needs: The orientation pathway is currently integrated into 50% of our specialty clinics, so we plan continued integration for remaining clinics due to the pathway’s success. There is a continuing need to address RN reluctance to change through RN education regarding MA scope of responsibility. Future needs for dedicated MA educator for targeted support.