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PCMH - Have a Well Trained Staff in 30 days

Healthcare in America. A controversial topic where everyone from local physicians to politicians in Washington seems to have a strong opinion. The fundamental challenge for healthcare reform centers on the ability to expand access to all US residents, all the while completely restructuring the process to provide superior care at a lower overall cost.

While the politicians duke it out in Washington, a new model of healthcare delivery has developed…the Patient-Centered Medical Home.

Over 12,000 clinics have already jumped onboard the PCMH train. Although definitive results are still pending, over 60,000 clinicians have put patients at the forefront of care. Research thus far shows that PCMHs build a better relationship between patients and their clinical care team, which drastically improves the quality of care, patient experience, staff satisfaction, and reduce health care costs.


If you’ve decided to make the shift, congratulations! It’s a tall undertaking, but one that will help everyone in the long run. Changing to a PCMH mindset takes more than one person, it takes a coordinated team effort.


In this article, we’ll dive into some of the ways to make this adjustment with minimal downtime required for training.


The Training Process


PCMH 2017 has evolved from the former version, PCMH 2014. However, the basic concepts remain the same. The training process is a three-step process that involves commitment, transformation, and success!


Commit - The practice learns the NCQA PCMH concepts and begins to apply them to their practice. Once the practice is knowledgeable of the concepts and has begun transforming into a PCMH, they enroll through the NCQA Q-Pass system ( and complete an initial questionnaire.


Transform - Practices transform over time, building on successes. Along the way, NCQA conducts check-ins with the practice to gauge progress and to discuss next steps in the evaluation. Virtual check-ins, which are conducted online via screen sharing technology, provide practices with immediate and personalized feedback on what is going well and what needs to improve.


Succeed - Each year, the practice checks in with NCQA to show its ongoing activities are consistent with the PCMH model of care. This is part of the Annual Reporting process and includes attesting to certain policies and procedures and submission of some data. This process sustains the practice’s recognition and fosters continuous improvement that means the practice succeeds in strengthening its transformation and, as a result, patient care. NCQA has the only national program that supports ongoing quality improvement in this way.


Why Train?


High-performing health centers recognize the importance of enabling their staff with the right skills to be successful. Embracing the right level of PCMH training, process and management training, IT training, enablement and engagement can dramatically reduce attrition and safeguard your workforce investment.


Why is this important?


Employees who do not feel they are achieving their career goals or performing effectively in their positions are 12 times more likely to leave their jobs.  This number skyrockets to 30 times more likely for new hires!


Training the staff helps patients, too!  Team objectives are met 90% more often by increasing team skills. Patient satisfaction increases among companies with well-trained staff. In addition, training increases business value. Teams that are well trained can increase productivity by as much as 10% or more.


Organizations with well-trained staff significantly outperform their competition because staff uses newer approaches to work, are more dynamic, collaborative and get things done effectively in a constantly changing environment.


Common Excuses for Not Training


Excuses, excuses, excuses! Everyone has one. When attempting to get people to make a fundamental shift in the way they approach things, there can be a lot of pushback initially. This pushback will be followed by excuses on WHY the shift shouldn’t happen, but you have to realize overcoming objections is just part of the process.


Here are three of the most common excuses:


  1. We don’t have time.


In the clinical world, we all wear many hats. Especially in the FQHC environment. One of the most important things to keep in mind for employee satisfaction is that dissatisfaction with employee development efforts appears to fuel many early exits for companies (view here) according to an article by Forbes.


Workers generally value these opportunities when they find value in them. If the workers are learning something or being provided with a chance to learn a new skill, they’ll be engaged and happier.


Show value and everyone will make the time.


  1. We don’t have any training materials


Fear not! The internet has a ton of excellent resources that can help you learn how to train your staff. This includes


  1. We are all experienced professionals and we don’t need any more training.


This is NOT true. Everybody needs training…especially in the healthcare industry. As regulations change the industry, the standards begin to change as well. For PCMH, the 2017 shift recently got away for the 2014 version where some of the aspects of the program changed. Training is unbelievably important to be able to set your team and practice up for continued success in the future.


Benefits of Training


PCMH requires a lot of change and people must have reasons for the change, otherwise the excuses we already mentioned become based in reality. People must also be prepared for change, it can’t just be dropped on them. Introduce your staff to the idea that changes are coming months ahead of time. This way, they’ll also be more open to the transformation.  


For best practices, people must be involved in the process of change. If people are involved in the planning stage, they'll be involved in the implementation. Therefore, it’s important not to do too much for them.


By training your staff around the innovative concepts of PCMH, you are empowering them to add value to the organization beyond fulfilling their day-to-day roles. The beautiful part about PCMH training? It supports different learning styles and models which also helps the staff accept change. Some of these methods are:


  • Online learning, audio tapes, and books
  • On the job evaluative experiences (experience is worthless unless you evaluate it) 
  • Peer teaching, YouTube, educational conferences and seminars 
  • Expose them to infectious people – nothing like talking to someone excited about change


Competencies Required for an effective PCMH Program


The shift to proper training must come after you understand what you need to teach. This is the essential knowledge and skills that enable people to perform the required tasks for their jobs and adapt to change.


[Check out our article on the 16 competencies for PCMH here]


The shift begins with understanding that you’re not looking to turn-and-burn patients like the system has rewarded in the past. Now, you must look at taking a holistic whole-person care, that is systematically based, with practice-based learning.


With a shift to the patient-centric healthcare, it requires teamwork, communication, and professionalism. The teamwork is required now to take a look at the overall health of the patient, especially with the importance of chronic disease management. Chronic disease management requires integration of care with a plan for coordination and transition of care directives in place.


Additionally, you’ll need the proper IT services set up to make sure the coordination of care is in place.


Designing an Effective PCMH Training


Now we’re getting to the meat and potatoes of this article! Now that we have defined the purpose, excuses, and benefits of training, we get to the question of: “How do you design an effective training program?”


I’m glad you asked…


Creating a successful training program begins by asking the right questions and taking time on the plans to build the program in the right way. You start by conducting a needs assessment and analysis. This will help you figure out your strengths, your weaknesses, and the places where you need more support. You’ll be able to figure out if your organization really needs in-person training or if a written communication course will do? You’ll also be able to discover who really needs the training, discover what they need to learn, how best will they learn, and what learning is required.


All of this is extremely helpful in identifying the performance gaps which will lead to you being able to effectively design your training “matrix”. When designing your program, important considerations to keep in mind are the scope of training required, as well as the level of complexity. This will be determined by the previous step of discovering your audience. When you’ve identified this, you’ll be able to figure out if how many trainers you need, the types of facilities that are required for the training, the number of resources required, and if you’ll need to print out any quick-resource guides.


When you’ve finally gotten to the point where you can start putting together the content of the training, remember that it’s important that you customize the curriculum for adult learning – facilitate, don’t dictate!


The best training uses real-world scenarios, using lots of stories, to create a link in the mind between training and work responsibilities. This will help your staff to digest the information they’ve just learned and apply it to their new job responsibilities with less mental friction.


Resources to Help You With Training


Phew. We’ve covered a lot of ground so far. Now that we know what we need to do, there are some resources available to you that can help make the entire process easier to design and implement!


The first is the organization who has established the PCMH program. The NQCA ( has a treasure trove of resources available to help with any aspect of the program that you might need. This includes on-demand and live webinars, as well as training on the basics of PCMH 2017. This is most definitely the place to start if you’re trying to put your program together on your own.


Another great resource you would want to investigate is the Patient-Centered Primary Care Collaborative ( This resource has a tremendous amount of academic type learning resources for all levels of learning.


Visualutions is an amazing resource that you can take advantage of as well. We have experience designing training programs for all types of clinics, giving them a shortcut to success. Our made-for-you system will get you up and running in no time flat – without having to go out and do the research yourself. Our PCMH program is lead by Dr. Linda Pepper, who has over 20 years of experience in strategic business analysis and consulting for healthcare organizations. Since 2009, she has specialized in leading practices to transform through care models such as Patient-Centered Medical Homes and Affordable Care Organizations.