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Reconfiguring Health Workforce Policy So That Education, Training, And Actual Delivery of Care Are More Closely Connected

(Chapel Hill, NC) –  The health care workforce in the United States needs to be reconfigured to better meet the needs rapidly changing healthcare delivery system but neither regulatory policies nor market forces are keeping up, according to Tom Ricketts and Erin Fraher at the Program on Health Workforce Research and Policy, a program of the Cecil G. Sheps Center for Health Services Research at the University of North Carolina at Chapel Hill.

“The focus of health system innovation has been on reorganizing care delivery processes, reengineering workflows, and adopting electronic technology to improve outcomes with little attention being paid to train workers to adapt to these systems and deliver patient care with a more coordinated approach,” said Tom Ricketts, deputy director of the Cecil G. Sheps Center for Health Services Research, and professor in the Departments of Health Policy and Management and Social Medicine who co-wrote the piece along with Erin Fraher, an assistant professor in the departments of Family Medicine and Surgery.

The results of their findings were recently published in the article “Reconfiguring Health Workforce Policy So That Education, Training, And Actual Delivery Of Care Are Closely Connected,” in the latest issue of Health Affairs (November 2013). They argue that training and education should be connected more closely to the actual delivery of care and describe how health workforce policy has been done, illustrate some specific changes under way, and how those are changing the health care workforce. The article also suggests that closer links need to be built between the day-to-day caring for patients and the training of the people who deliver that care.

Their research has shown that early adopters of accountable care organizations (ACOs), patient-centered medical homes, and integrated health care networks find their workforce shifting from acute care towards community- and home-based settings with increased roles for physicians, nurses, social workers, patient navigators, outreach coordinators, and other clinicians to provide enhanced care coordination, better medication management, and improved care transitions. However, the training of these health professionals lags behind the care delivery reforms because it remains largely insulated from change behind the walls of schools of medicine, dentistry, pharmacy, and nursing. Medical training is being done primarily in hospitals, while the greatest challenges are found with coordinating care in multiple outpatient settings.

“In the past, health-care professionals were seen more as parts of a puzzle that must be carefully fit together rather than as fungible resources that can be crafted or remade to help build a truly reformed and more effective health-care delivery system,” Fraher said.

For the abstract of the article, please see this link.  Access to the full article requires a subscription.


For more information please contact:

Lisa Beavers, Program on Health Workforce Research and Policy