Regional Quality Lead Region 9

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Exit Interview Summary:

Personal Factors for Terminating Employment with MinuteClinic

The biggest personal factor was work-life balance and the need for a more regular schedule. In addition, I have always wanted to try full-scope primary care in a health system with interconnected resources where I am able to manage my own panel of patients.

Work Factors for Terminating Employment with MinuteClinic

Uncertainty regarding the future of MinuteClinic and what changes will look like as RQL and at the clinic-level

Mixed messages from leadership

                                                               i.      Changes in leadership with restructuring of RQL role

As a newer RQL, I feel that the role training could have been better defined (this is thankfully a current initiative). When I started, there were intranet resources but most of the links did not work initially. It was difficult to balance and somewhat confusing to understand the scope of my role when there were competing priorities with RQL management vs regional SPM priorities for the RQL role.

Abrupt change and restructuring MN regions from three to two. This was a difficult transition with an increase in number of clinics and staff within the region in addition to having to split the role and admin time with another RQL. This was the catalyst that made me to start applying for new positions (Working 30 hrs per week in the clinic and >10hrs RQL time per week was tiring. Less schedule flexibility.)

                                                             ii.      Messaging surrounding primary care practice in MinuteClinic. Rebecca and you both have said that you don’t think MC is headed fully toward primary care but the messages that we are hearing from upper leadership is that MinuteClinic will be transitioning to primary care.

Lack of trust that necessary resources and network will be in place to support transition to primary care or other future changes to practice.

                                                               i.      Lack of trust originates from a track record of making assurances but not delivering.

For example, staff were told that there would be a team of care coordinators that would own the referral process, but this never came to fruition.

Referral process is now owned by providers (with minimal support from care coordinators). Furthermore, the referral process feels like wasted time creating more admin work for staff when one goal was to eliminate admin tasks for providers.

Another example is assurances of additional time for interpreter services. Patients were supposed to be able to schedule additional appt time for interpreter services and we were told about this potentially very helpful change almost a year ago and it has still not happened.

PCAs were brought in to address the need for more support staff. While we had some amazing PCAs, patient scheduling was never adjusted to reflect the more limited scope of PCAs. Instead of simplifying provider tasks, the verbal order process created work for providers and providers ended up using work-around processes to keep up with volume when working with PCAs.

                                                             ii.      Feeling as if staff concerns are not consistently heard/acted upon.

First of all, I have to say that I think SLC is great although I think the individuals that fill these roles need more hours allotted for these duties and additional compensation as well. I do see MC trying to incorporate staff feedback through surveys, SLC, and SPMs.

At times, the SLC “wins” feel like a consolation prize (small changes that while nice, could b