Workforce Innovation: Development and Integration of a New Support Role to Improve Clinic Care Team Workload

It is well known that the nursing workforce shortage continues to worsen, and the COVID-19 pandemic has exacerbated the staffing gaps experienced in ambulatory care nursing. The impact of the “great resignation” has been felt throughout healthcare via increased workload and burnout experienced by staff and nurse leaders. Turnover rates for registered nurses (RN), licensed practical nurses (LPN), and unlicensed assistive personnel (UAP) such as medical assistants (MA) continue to rise, and with it a need to replace those that leave the occupation or workforce entirely (AACN, 2020; BLS, 2022; MGMA, 2021). The US Labor and Statistics Occupational Outlook Handbook (2022) notes MA employment growth alone is projected to increase 18% by 2030, double the average of other occupations. Additionally, the impact of staffing concerns on nurse leaders is significant, negatively impacting nurse leaders' emotional health, and as a result, their ability to lead their teams effectively and remain in leadership positions (AONL, 2021).
Healthcare organizations employ various roles to support ambulatory patient care in the clinic setting. From a nursing perspective, this may include RNs, LPNs, and UAPs to support delegated nursing tasks. Nurse leaders are accountable for maintaining a safe environment for patients and are aware of the knowledge, skill level, and limitations of licensed nurses and UAPs. This expertise positions nurse leaders to effectively lead workforce innovation, and this important work begins with the nursing process step of assessment.
A current state assessment completed by nurse leaders in our organization revealed tasks that do not require formal clinical expertise yet are important aspects of providing safe and quality patient care (i.e., escorting patients, cleaning and stocking supplies in exam rooms, and doing equipment checks). This presented an opportunity to develop a unique on-the-job trained UAP that can offload specific support tasks and allow our formally educated team to focus on direct patient care including medication administration, patient outreach, and provider support.
The purpose of this poster presentation is to share a process with nurse leaders that can be used to innovate and develop a new UAP role in their clinic setting and integrate it into the care model effectively. The poster will review our process from concept and assessment to pilot and spread. We plan to engage viewers by sharing a case study and providing examples of tools used and lessons learned from problem statement through implementation. We also plan to share the evaluation and outcomes of the project one-year post-conception, including how it has lessened the negative impact of staffing shortages and began to build a pipeline of individuals interested in the nursing profession. After completing this learning activity, the participant will be able to discuss practices and tactics to clearly delineate nursing scope of practice and UAP scope of work and demonstrate nurse leader competencies critical to the successful development and implementation of a new UAP role.