Performance Improvement 1999. Health Professions


TITLE: Assessing Ambulatory Primary Care Training: Costs, Methods and Quality

ABSTRACT: The purpose of this study was to create a meaningful data set to estimate the cost of primary care medical education, including training costs for nurse practitioners and physician assistants, in the ambulatory care setting. Although well-developed educational and financial infrastructures support hospital-based education of the health professions, a similar infrastructure for ambulatory care training is nascent. This study addressed whether teaching ambulatory sites have higher costs than non-teaching sites, and whether the productivity of clinicians engaged in ambulatory teaching differs from that of clinicians who are not teaching. An advisory panel of leading investigators and teaching clinicians helped to guide a literature review of the costs of ambulatory training and related data collection analysis. Site-level cost and operations information was obtained from HRSA and external sources. In addition, a survey of 98 ambulatory teaching sites was conducted. The study found that operating costs of teaching ambulatory care sites are about 36 percent higher than costs of similar non-teaching sites. Of this cost differential, about 65 percent is due to costs that are attributable to education, while 35 percent stems from educational infrastructure costs. Like their hospital counterparts, teaching ambulatory care sites tend to be larger and more organizationally complex than non-teaching sites, offering more specialty care and seeing more patients. Educational experiences were diverse, including clinical training, core clerkships, lectures and seminars, and community service projects. Ambulatory care educators identified the following as conditions needed to assure quality in ambulatory training: a strong and interested faculty, a clinically diverse patient base, and the integration of training into day-to-day operations. This study has led to a preliminary project to determine a method for assessing the value added to ambulatory care settings by educational activities.

AGENCY SPONSOR: Bureau of Health Professions


PHONE NUMBER: 301-443-6920

PIC ID: 6358

PERFORMER ORGANIZATION: Northeastern Ohio Universities, Rootstown, OH

TITLE: Consortium Development for Health Professions Training in Community-Based Settings

ABSTRACT: The development of academic/community consortia for education and training in the health professions can increase opportunities for students and trainees, enhance the relevancy of training experiences, and benefit both the consortium's academic and community-based participants. This project focused on consortia that train a variety of health professionals in an interdisciplinary manner in community-based settings. The goals of the project were to: (1) identify consortia, (2) determine what types of community-based and academic organizations make up these consortia, (3) determine the extent to which health professions education and training carried out by these consortia are done in an interdisciplinary manner, and (4) identify some of the challenges that face these consortia. This study identified consortia that not only educate and train disciplines other than, or in addition to, physicians, but that also include community-based providers and organizations as partners. The study found that academic-community consortia for health professions education vary considerably in their missions, types of participating organizations, governance structure, educational approaches, and professional disciplines of the trainees. Commonalities among the consortia included shared goals for both education and service delivery, use of a legally binding agreement to finalize commitment from partners, significant funding from Federal, State and private sources, and encouragement of trainees to practice in underserved areas. In addition, several factors that might impede the success of a consortia were identified. Findings are being used to guide program planning to encourage interdisciplinary training. Findings will also be used in providing technical assistance to applicants or grantees regarding important factors to consider in developing consortia.

AGENCY SPONSOR: Bureau of Health Professions


PHONE NUMBER: 301-443-6865

PIC ID: 6251

PERFORMER ORGANIZATION: The George Washington University, Washington, D.C.

TITLE: Strategies for the Recruitment, Retention, and Graduation of Hispanics into the Baccalaureate Level of Nursing

ABSTRACT: The Healthy People 2000 objectives for the Nation specify an increase in the proportion of all degrees in the health professions and allied and associated health professional fields awarded to minorities, from the 1985-1986 baseline of three percent to 6.4 percent by the year 2000. Recent data suggest that fewer than two percent of the 2.5 million Americans with current licenses to practice as registered nurses in March of 1996 were of Hispanic background, and Hispanics are seriously underrepresented in baccalaureate nursing programs. Only very slight gains in the admission of Hispanic students into nursing schools have been made since 1972, when the National League for Nursing first began collecting ethnic classification data. The admission rate for Hispanic nursing baccalaureate students has almost consistently remained below three percent. Based on a literature review and in-depth interviews with administrators, faculty and students at eight schools of nursing, this study has developed a model that can be used as a conceptual framework by Institutions of Higher Education (IHEs) seeking to increase the proportion of Hispanic Americans admitted to baccalaureate programs as their initial entry into nursing education. The model explicates promising strategies for the recruitment of Hispanics into baccalaureate nursing programs, retaining them after they are recruited, and assuring their graduation from those programs. It also suggests implementation issues that may arise when these strategies are put into practice.

AGENCY SPONSOR: Bureau of Health Professions

FEDERAL CONTACT: Ernell Spratley

PHONE NUMBER: 301-443-1915

PIC ID: 6249