Job Task Analyses Confirms Beliefs

Medical director and attending physician job task analyses surveys show specific skills needed for setting.

Job Task Analyses Confirm Unique Knowledge, Skill Sets Needed by PALTC Physicians and Medical Directors

Members of AMDA – The Society for Post-Acute and Long-Term Care Medicine, as well as other practitioners, were recently asked to participate in two job task surveys—one for medical directors, and one for attending physicians—to help shape the body of knowledge for post-acute and long-term care medicine (PALTC) and to guide the future of certification, competence curricula development, education, and other programming, tools, and resources. The detailed job task analyses will be released later this year.

Briefly, the surveys’ results reaffirm the unique nature of PALTC and the knowledge and skill sets medical directors and attendings need to be effective in this setting. The surveys also show that practitioners are being asked to provide more and increasingly complex services. “There has never been an effort to identify the tasks and knowledge required for attending physicians to practice effectively in this care setting. This is groundbreaking,” says American Board of Post-Acute and Long-Term Care Medicine (ABPLM) Chair Thomas Edmondson, MD, CMD. The two job task studies were designed and administered by the ABPLM.

Dr. Edmondson and his colleagues compiled two groups of key experts—from inside and outside the Society—who worked together to develop task statements for medical directors and attending physicians. The surveys were reviewed extensively, refined, and then disseminated. They were distributed and promoted through presentations at scientific meetings, email, and communications with leaders from other societies.

The number of respondents exceeded expectations, with nearly 1,000 surveys completed across the two studies. Findings consistently showed that practitioners felt that there was a specific knowledge base and skill set necessary to practice medicine successfully in PALTC. Respondents are using these skills not only in nursing homes and rehab facilities, but also in hospice, home care, assisted living communities, and long-term acute care hospitals. “There is so much data. I was especially impressed by the number of non-Society members we received responses from,” says Robert Kaplan, MD, CMD, Vice-Chair of ABPLM.

PALTC has changed and evolved over the years, as have the roles and responsibilities of medical directors and attending physicians; and the surveys’ results reflect this. “Comparing what we were responsible for in the early ‘90s to now, the bar is much higher. Care is more sophisticated, and patients are sicker and more complex,” says Dr. Kaplan. “What was considered the standard for hospital care 20 years ago is now the standard in our setting.” At the same time, he notes, regulations are mandating initiatives such as antibiotic stewardship and antipsychotic use reduction; and facilities often look to physicians to take the lead on these efforts. “It all comes down to outcomes,” Dr. Kaplan observes. “Regulators, health systems, payors, patients and families, the public, and others are all expecting better outcomes.”

The job task analyses are anticipated to be published in JAMDA later this year and shared with other national organizations via articles and presentations. The survey results will drive changes in the Society’s educational offerings, ABPLM certification, and beyond. “We will be looking to both surveys to see what we can do to further professional development goals,” says Dr. Edmondson. “We also will use it to educate administrators, other colleagues and stakeholders about the role of the medical director and the attending physician.” He adds, “There is a growing desire to educate health care leaders about what physicians need to bring to their roles as post-acute and long-term care practitioners. More than ever, these decision makers are seeking a highly qualified workforce, and we will be working to prepare physicians to meet these needs and expectations.” All of this work will be done with careful due diligence, Dr. Edmondson emphasizes. “We have to be thoughtful about this, and it will take time.”

Dr. Edmondson stresses, “Our goal is to educate all physicians who want to practice in PALTC. We welcome with open arms anyone who wants to work in this environment.” The job task analyses will be used to strengthen the Certified Medical Director credential, and to develop an inclusive and comprehensive certification program for attending physicians that will prepare these practitioners to embrace opportunities as well as tackle challenges. “This comes at an opportune time, when health systems and payors alike are demanding more from practitioners.”  Dr. Kaplan adds, “This is exciting for us. We are experts in this setting, and these job task analyses will help take our education and certification efforts to a higher level.”