Case studies assist in understanding key areas of concern in a healthcare enviro

Case studies assist in understanding key areas of concern in a healthcare environment. A case study is a real-world experience that allows the student to apply their knowledge. Case studies provides a comprehensive view of diverse theories and the complexity of administrative actions in resolving issues that occur in healthcare operations.
CASE 56
Give Us Scope!
Jenn Block
You are a clinical operations leader overseeing acquired physician practices. Due to reimbursement changes, acquisitions of physician practices topped 80,000 in 2018 (Rosenberg, 2018). It is critical to establish a shared understanding of important areas that can create risk for the organizations involved, including such items as the scope of practice for medical assistants (MAs). Having this type of discussion prior to an acquisition is important because of the potential impact it could have on work distribution and organizational policies after acquisitions. As the formation of unit-based teams and role optimization have become commonplace, this has become even more essential. As a clinical operations leader, you have individual cultures to address within these newly acquired physician practices. However, you have some physicians in the practices who have maintained autonomy for decades who are resistant to limiting, or even expanding, the scope of practice for MAs.
Leadership has asked for your help with this challenge. You must instill both a sense of corporate culture and duty to the greater good, while maintaining physician autonomy. To ensure a smooth acquisition, your bosses have asked you to have discussions in advance with all the physicians regarding expectations. This includes a conversation concerning not only corporate culture but also physician autonomy and expectations to conform to corporate policies and standards.
Finding a scope of practice for MAs has been elusive—like chasing a rainbow, it is always out of reach. However, some states like California explicitly outline what is and isn’t acceptable to delegate to an MA. Most states, however, subscribe to the notion that it is the physician’s responsibility to determine what they feel comfortable delegating, and provide only guidelines preventing them from doing anything that would be considered “practice of medicine” or any task that requires the exercise of medical judgment. There are two foreseeable issues with this vague guideline. First, if you were to ask 10 different people to define what that means, you would likely get at least a handful of answers. Secondly, because private practices are acquired with their own unique cultures and practices, it is safe to assume that they also have different beliefs when it comes to what they delegate to their MAs.
One reason this is important to leadership is the shift in risk from the individual practice to the organization as a whole, not to mention the matter of patient safety. One benefit of joining a larger organization is the economies of scale that come from shared resources. Sharing resources can include sharing clinical staff to respond to the need for coverage of increasing or decreasing patient volumes. Moving staff means changing cultures from one independent office to another. Because offices will often have different workflows, this opens the possibility for safety occurrences and a variation in practices such as the scope of practice for MAs if a corporate policy has not been established. One example of potential variation is medication administration. In one practice, a physician who orders a medication will verify that it is not on the patient’s allergy list. In another, the physician might expect the MA to do this verification. In the absence of established protocols, a traveling MA could create a potential sentinel event by administering the medication without verifying the patient is not allergic to it.
With all these things in mind, how should you proceed?
TIP: When reviewing your case study summarize key areas to that should be addressed. Keep in mind the expectation of regulatory bodies to ensure compliance of appropriate care planning.
References:
American Association of Medical Assistants. (2020). State scope of practice laws. https://www.aama-ntl.org/employers/state-scope-of-practice-laws#COscope
Becker’s Hospital Review. (2012, March 1). 5 considerations for successful physician acquisitions. https://www.beckershospitalreview.com/hospital-physician-relationships/5-considerations-for-successful-physician-acquisitions.html
Buchbinder, S., Shanks, N., Buchbinder, D. & Kite, B. (2023). Cases in Health Care Management. 2nd Ed.; Jones & Bartlett Learning.
Medical Board of California. (2020). Frequently asked questions: Medical assistants. https://www.mbc.ca.gov/Licensees/Physicians_and_Surgeons/Medical_Assistants/Medical_Assistants_FAQ.aspx
Rosenberg, J. (2018, March 21). Hospital acquisition of independent physician practices continues to increase. American Journal of Managed Care. https://www.ajmc.com/view/hospital-acquisition-of-independent-physician-practices-continues-to-increase
Instructions
In this activity you will complete an analysis of the identified case study. Your analysis should include a discussion of the issues in the case which detail the contributory factors and the impact should the issue go unaddressed. In addition please address the following:
Identify the issue
Identify the relevant parties
Review policies and procedure and regulations that may impact your decision
Conduct additional research to support your decision making.
Provide a description on how you arrived at your recommended solution.
Discuss one to two ways to minimize future occurrences, including how you would measure the effectiveness of solution.
TIP: An analysis is supported by research of your identified problem using trade journals and peer reviewed articles.
Requirements:
(1) page paper plus (1) title page and reference page
Format your paper using APA style
Include (2) scholarly references used as in-text citations to support your writing (these should be under 5 years old)
Access professional journals to conduct your research.
Rubric
Analyze the issue of the case and relevant parties
Identify the issue
Identify the relevant parties
25 pts
Full Marks
0 pts
No Marks
25 pts
Recommended Solution
Provide a description on how you arrived at your recommended solution.
25 pts
Full Marks
0 pts
No Marks
25 pts
Minimize Future Occurrences
Discuss one to two ways to minimize future occurrences, including how you would measure the effectiveness of solution.
25 pts
Full Marks
0 pts
No Marks
25 pts
Supporting Documentation
Review and identify policies, procedures and regulations that may impact your decision
Conduct additional research to support your decision making.
15 pts
Full Marks
0 pts
No Marks
15 pts
Mechanics
Responses are written at the college level. Assignment is free of spelling and grammar errors. Follows APA guidelines set forth in the instructions.
10 pts
Full Marks
0 pts
No Marks
10 pts
Total Points: 100