Standardization of Provider Support Care in a Specialty Medical Clinic

In the United States, the societal title of "nurse" has a broad definition that includes varying educational levels, ranging from medical assistant certification to a doctorate degree, and a wide spectrum of provider support roles for both clinicians and the general public. The differences between certifications and licensures for these support roles are often unclear to everyday public. Medicine has evolved to incorporate specialties for better patient care. Medical specialists may have a diverse provider support staff to meet the needs of the patient population. The support staff may include medical assistants (MAs), licensed practical nurses (LPNs), and registered nurses (RNs). This diverse staff with varying educational levels creates challenges in providing consistent quality nursing care. Discrepancies, such as patient teaching, education, critical thinking skills, and communication skills, can occur. Trust among colleagues and patients becomes an issue when inaccurate or inconsistent information is given to patients from staff members, who have good intentions but may lack the education to give sound information. The purpose of this project was to establish protocols to standardize provider support staff tasks, reduce variability in care, and decrease frequency of poor communication or clerical errors. To achieve this task, the first need was to determine current staff practice for triage calls and teaching. A literature review analyzed the similarities and differences of provider support staff in order to maintain diversity within a clinical setting and to determine if national standards have been established. The nurse practice act in each state clearly states the scope of practice for LPNs and RNs. Most states do not have a scope of practice for MAs. The practice of MAs depends on what the licensed practitioner teaches or allows the MAs to do. Medical offices, compared to hospital settings, do not define the scope of practice and roles. Several steps where taken to address variability in care. First, identifying gaps and shortfalls of provider support care and patient teaching starts with determining current staff care with triage calls was needed. A survey helped identify gaps and in the development of a protocol/tool. A protocol was then developed and proposed. A trial implementation was initiated to aid in reducing the variability of patient care. Staff implemented the protocol in an attempt to bridge the gaps that exist with varying staff educational levels. Provider support staff members are instrumental in the care of the patient in a medical specialty clinic. They are usually the first line in clinical patient care. Despite the varying educational levels of the provider support staff, each staff member adds value and contributes to patient care. Establishing a standard protocol for triage calls will diminish the variability of care, improve the quality of that care, and improve outcomes.