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    Cristy Good
    Cristy Good, MPH, MBA, CPC, CMPE

    In large medical practices, some medical assistants (MAs) may be assigned to work at multiple sites, not just one location. This approach addresses staffing concerns by utilizing MAs across diverse clinic settings — including client sites, nursing facilities and hospitals — to ensure they remain engaged and employed full time.

    To effectively manage and leverage MAs’ skills, adopting best practices is essential for addressing common issues, such as:

    • Assigning tasks with attention to employee requests and preferences
    • Fostering unity and seamless integration of MAs across multiple sites with communication and community-building by integrating them smoothly into each office’s operations and fostering a sense of community through consistent contacts
    • Ensuring easy access to physical and digital resources for MAs on the move
    • Clarifying standard rules and addressing liability issues (e.g., travel time compensation, time tracking requirements, mileage reimbursement, and policies on tardiness and expected arrival times, particularly during inclement weather or last-minute location changes).

    How common are multisite MAs?

    While traveling MAs are not as common as permanent employees, they do play a valuable role in filling shortages or temporary vacancies within medical facilities. The current staffing shortage across the industry has likely necessitated the use of multisite MAs.

    An April 9, 2024, MGMA Stat poll found that almost two-thirds (64%) of medical groups report using multisite MAs, while 36% do not. The poll had 583 applicable responses.

    What are the advantages and disadvantages of employing multisite MAs?

    Multisite MAs provide healthcare practices with the flexibility to address staffing shortages or temporary needs. They can be hired for short-term contracts, typically ranging from a few weeks to a few months. This flexibility allows healthcare practices to adapt to changing demands and maintain continuity of care.

    Traveling MAs often have experience working in various healthcare settings, such as clinics, hospitals and doctors' offices. This diverse experience enables them to quickly adapt to new environments and work efficiently with minimal training or orientation.

    With the growing demand for MAs, healthcare practices may struggle to find qualified candidates for permanent positions. Employing a traveling MA expands the pool of available professionals, ensuring timely fulfillment of staffing needs.

    Cost-effectiveness: Traveling MAs are typically paid an hourly rate and a weekly stipend for living expenses, offering healthcare practices a cost-effective solution without the need for relocation assistance or long-term employee benefits.

    Expertise in clinical and administrative duties: Traveling MAs are versatile, skilled in both clinical and administrative tasks such as vital signs, injections, sample collection, exam assistance, answering phones, scheduling appointments and managing patient information.

    Temporary support for permanent staff: Hiring a traveling MA provides temporary support to permanent staff, preventing burnout and allowing time off for focus on critical tasks.

    Best practices for scheduling multisite MAs

    • Implement a centralized scheduling system to store MA availability, skills and preferences ensuring a comprehensive resource overview across different sites.
    • Standardize scheduling processes and guidelines to promote consistency and fairness, streamlining assignment of shifts and tasks while minimizing confusion.
    • Invest in scheduling software to automate and provide real-time updates on MA schedules, enhancing management and tracking efficiency across multiple sites.
    • Match MA skills with site needs by considering workload and expertise requirements, placing MAs where they are most needed.
    • Ensure transparent communication with MAs regarding schedules and changes, leveraging technology like email, messaging apps or scheduling software for clarity.
    • Anticipate unforeseen staffing changes with contingency plans, such as a pool of on-call MAs or cross-trained MAs to work at different sites if needed.
    • Optimize travel for MAs across multiple sites, aiming to reduce travel time and fatigue, thereby enhancing overall productivity.
    • Regularly review and adjust schedules based on feedback, workload changes and any emerging needs, continuously improving scheduling.
    • Guarantee MA access to essential resources and support for effective performance at various sites, including clear guidelines, comprehensive training and necessary equipment and supplies.

    Best way to determine assignments while responding to employee requests/preferences:

    1. Require employees to submit formal requests for work assignments, ensuring all necessary information is provided upfront and reducing the need for rework or guesswork.
    2. Implement a clear template for request submission and make sure everyone understands the new process.
    3. Use a single platform or system to collect and organize all incoming requests, like project intake software or a designated email address, thereby preventing them from getting lost or forgotten and allowing for easy tracking and prioritization.
    4. When reviewing incoming requests, prioritize them based on their alignment with the company's strategic goals, considering the impact of each request on the overall objectives and prioritizing those that contribute most directly to the company's success.
    5. Designate an employee to oversee the incoming work requests and assignment management, such as a team lead or project manager with appropriate authorization to assign projects or adjust deadlines as needed.
    6. Consider employee preferences and skills when assigning work, considering their expertise, interests and development goals. Assigning tasks that align with employees' strengths and interests can increase motivation and productivity.
    7. Explain the bigger picture and significance of tasks to employees, highlighting how their work contributes to the project or company goals. This understanding can boost their motivation and commitment to the task.
    8. Specify task requirements and provide detailed instructions completion, ensuring employees understand their objectives and steps to achieve them.
    9. Promote a transparent work environment by encouraging employees to log their tasks and deadlines into a shared system or timesheet, enhancing visibility of workloads and availability for improved task assignment and coordination.

    Key challenges for medical practice supervisors/managers:

    Recruitment and Training:

    • One of the main concerns is the difficulty in finding qualified MAs, especially in rural areas.
    • Identify candidates with bilingual skills, because multisite healthcare facilities may require MAs who can communicate effectively with diverse patient populations.
    • MAs should possess strong organizational and interpersonal skills to effectively manage their responsibilities, especially important if they’re required to manage a travel schedule.
    • Hiring MAs with a general knowledge of the health problems relevant to their assigned program is optimal; however, this is not always possible, so ensure the bandwidth for training.

    Supervision and Communication:

    • In multisite settings, MAs may encounter delays in communication and feedback from central office supervisors, affecting information transfer and supply receipt.
    • Maintaining consistent on-site supervision of MAs is recommended to improve program implementation fidelity and ensure effective communication.

    Key challenges for MAs:

    1. Frequent and demanding travel: MAs often move between locations, facing physical and mental strains. Adapting to new environments, work cultures and colleagues regularly adds to the challenge.
    2. Adapting to various protocols: With each healthcare facility having its unique protocols, procedures and systems, traveling MAs must quickly adapt to these varying work settings and understand each facility's specific requirements and expectations.
    3. Building patient rapport: Establishing trust and a connection with patients in a short time is difficult for traveling MAs. They must quickly form professional and empathetic relationships to ensure quality care.
    4. Teamwork and communication: Working with different healthcare professionals and support staff at each location, traveling MAs encounter challenges in establishing effective teamwork and communication due to unfamiliarity with colleagues' working styles and preferences.
    5. Learning electronic health record (EHR) systems: Each facility may use a different EHR system, requiring traveling MAs to quickly learn and navigate these systems, which can be challenging and time-consuming — especially if they are not familiar with the specific EHR software.
    6. Maintaining work-life balance: The job demands of constant travel and irregular schedules make it hard for traveling MAs to maintain a healthy work-life balance, complicating the establishment of routines and personal activities and relationships.

    Standard rules and liability considerations:

    When it comes to standard rules and liability considerations for managing multisite MAs in healthcare, it is important to establish clear policies and guidelines.

    Here are some best practices to consider:

    1. Determine whether MAs should be compensated for travel time between different sites. This can vary depending on local labor laws and organizational policies. Consult with legal and HR departments to ensure compliance.
    2. Implement a system for MAs to accurately record their working hours, including clocking in and out at each site. This can help track their time and ensure accurate payment.
    3. Establish a mileage reimbursement policy to compensate MAs for the use of their personal vehicles when traveling between sites; determine the reimbursement rate per mile and the process for submitting mileage claims.
    4. Clearly communicate expectations regarding punctuality and arrival times. Establish policies for MAs to follow if they anticipate being late due to inclement weather or last-minute changes to locations, such as notifying their supervisor or designated contact person as soon as possible.
    5. Develop policies and procedures for managing inclement weather situations. This may include guidelines for determining when it is safe for MAs to travel to different sites, alternative work arrangements or contingency plans for rescheduling appointments or tasks.
    6. Establish protocols for handling last-minute changes to locations. This may involve clear communication channels to quickly inform MAs of any changes and providing the necessary information and resources to navigate the new location effectively.
    7. Consult with legal and risk management departments to address liability considerations. Ensure that MAs are aware of their responsibilities and any potential risks associated with their work at different sites. Implement appropriate insurance coverage and risk mitigation strategies.
    8. Conduct regular training sessions and provide ongoing communication to inform MAs of policies, procedures and expectations related to travel; clocking in and out; reimbursement and inclement weather situations. This will help reduce confusion and ensure compliance.

    How to effectively communicate these policies and expectations:

    1. Develop written policies and expectations that clearly outline the organization's standards and guidelines for MAs, covering areas such as professional conduct, dress code, communication protocols, patient confidentiality and jobs responsibilities. Ensure easy access, either through an employee handbook or a centralized online platform.
    2. Conduct regular training and orientation sessions — in-person sessions, online modules or a combination of both — to familiarize MAs with the organization's policies and expectations. These sessions should provide detailed information on the policies, explain their importance, and address any questions or concerns.
    3. Establish open and transparent communication channels between MAs and organizational leaders, encouraging MAs to ask questions, seek clarification and provide feedback on policies and expectations. Hold regular team meetings and one-on-one discussions and utilize suggestion boxes or other anonymous feedback mechanisms, fostering a culture where MAs feel comfortable expressing their thoughts and concerns.
    4. Keep MAs informed about any changes or updates to policies and expectations through regular communication channels, such as email updates, newsletters or bulletin boards. Communicate updates quickly, and provide clear instructions on how MAs should adapt to the changes.
    5. Organizational leaders and supervisors should lead by example and demonstrate adherence to the policies and expectations. When MAs see their leaders practicing what they preach, it reinforces the importance of following the established guidelines. Leaders should also be approachable and available to address any questions or concerns raised by MAs.
    6. Provide regular performance feedback and evaluations to MAs — highlighting both areas where they excel and that need improvement — that align with the organization's policies and expectations, helping MAs understand how their performance lines up with the established standards. Provide constructive feedback through performance reviews, coaching sessions or informal check-ins.

    Maintaining sense of community with traveling MAs:

    Here are some strategies/ideas to achieve this:

    1. Regular communication:
      • Maintain consistent points of contact through regular communication channels such as email, phone calls or video conferences.
      • Assign a designated contact person or mentor who can provide guidance, answer questions and address concerns.
      • Schedule periodic check-ins to ensure that MAs feel supported and connected to the organization.
      • Provide access to resources such as training materials, guidelines and best practices to support their professional development.
    2. Create a sense of belonging:
      • Organize team-building activities, both in-person and virtually, to strengthen relationships among MAs and their colleagues.
      • Recognize and celebrate MA achievements and milestones, making them feel valued and appreciated.
      • Provide opportunities for MAs to contribute to the organization's decision-making processes and initiatives, making them feel like an integral part of the team.
    3. Establish a physical home base:
      • If feasible, consider providing a physical home base where MAs can return periodically to reconnect with colleagues, attend training sessions and access necessary resources.
      • Ensure that the home base is equipped with the necessary facilities and amenities to support their work and well-being.
      • Create a welcoming and comfortable environment that fosters a sense of community and belonging.

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