Effects of Guided Care on Providers’ Satisfaction with Care: A Three-Year Matched-Pair Cluster-Randomized Trial Jill A. Marsteller, PhD, MPP, 1,2 Yea-Jen Hsu, PhD, 1 Mei Wen, PhD, 3 Jennifer Wolff, PhD, 1,2 Kevin Frick, PhD, 1 Lisa Reider, MHS, 1 Daniel Scharfstein, ScD, 1,2 Cynthia Boyd, MD, 1,2 Bruce Leff, MD, 1,2 Lindsay Schwartz, PhD, 1 Lya Karm, MD, 4 and Chad Boult, MD, MPH, MBA 1,2 Abstract It is important to understand the effects of a new care model on health professionals’ satisfaction, which may help inform organizations’ decisions regarding the adoption of the model. This study evaluates the effect of the Guided Care model of primary care on physicians’, Guided Care Nurses’ and practice staff satisfaction with processes of care for chronically ill older patients. In Guided Care, a specially educated registered nurse works with 2–5 primary care physicians, performing 8 clinical activities for 50–60 chronically ill older patients. This model was tested in a 3-year matched-pair cluster-randomized controlled trial with 14 pods (teams of physicians and staff) randomly assigned, within pairs, to provide Guided Care or usual care. Physicians and Guided Care Nurses were surveyed at baseline and annually for 3 years. Staff were surveyed at baseline and 2 years later. Physicians’ satisfaction with chronic care processes, knowledge of patients, and care coordination were mea- sured, as well as Guided Care Nurses’ satisfaction with chronic care processes and staff perceptions of quality of care. Findings suggest that Guided Care improved physician satisfaction with patient/family communication and management of chronic care, and it may bolster staff beliefs that care is patient oriented. Differences in other aspects of care were not statistically significant. (Population Health Management 2013;16:317–325) Introduction C are for older patients with multiple chronic condi- tions is challenging because these patients have complex needs and receive care from multiple health care providers in multiple settings. 1 Researchers and practitioners have de- veloped new versions of the primary care model, such as the ‘‘medical home’’ (and ‘‘comprehensive primary care’’), to provide high-quality chronic care efficiently. These new ver- sions require new roles and work processes for physicians, nurses, and practice staff, and may affect their satisfaction with work and their practice climate. Literature has shown that physicians’ and nurses’ job satisfaction is related to burnout, 2–5 intention to leave, 6–9 and job turnover, 10–12 as well as patient satisfaction 13–16 and care continuity. 15,17 Practice climate is the extent to which practice staff share attitudes and behaviors supporting the collaboration and teamwork that are required to care for their patients. 18 A more favorable practice climate in primary care teams may be associated with increased patient involvement in their own health and health care, and patient trust of the physician. 18,19 Little is known about physicians’ and nurses’ satisfaction with the care they provide. However, available studies examining physicians’ views of office visits suggest that physicians’ perceptions of care are related to the quality and processes of care. 20–22 Such information on provider per- ceptions may help improve new models of primary care. Knowledge of the effects of a model on health professionals’ 1 Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland. 2 Johns Hopkins School of Medicine, Baltimore, Maryland. 3 College of Education and Human Services, Western Illinois University, Macomb, Illinois. 4 Kaiser-Permanente Mid-Atlantic States, Rockville, Maryland. Prior abstract presentations: Marsteller JA. Physician Satisfaction with Chronic Care: Results from a Three-Year Randomized Trial of Guided Care. Poster presentation to the AcademyHealth Annual Research Meeting, June 2010, Boston, MA. (Results of physician satisfaction with chronic care processes are presented.) Marsteller JA. Guided Care Nurse Satisfaction and Its Change over Time. Poster presentation to the AcademyHealth Annual Research Meeting, June 2010, Boston, MA. (Results of Guided Care Nurses’ satisfaction with chronic care processes are presented.) POPULATION HEALTH MANAGEMENT Volume 16, Number 5, 2013 ª Mary Ann Liebert, Inc. DOI: 10.1089/pop.2012.0091 317