Residency Practice Transformation: Implementation of Team-Based Care in an Academic Continuity Clinic.
Ambulatory Care Facilities
/ organization & administration
Attitude of Health Personnel
Continuity of Patient Care
/ organization & administration
Humans
Internal Medicine
/ education
Internship and Residency
/ organization & administration
New York City
Patient Care Team
/ organization & administration
Physicians, Primary Care
Preceptorship
/ organization & administration
Primary Health Care
/ methods
Surveys and Questionnaires
Journal
Journal of graduate medical education
ISSN: 1949-8357
Titre abrégé: J Grad Med Educ
Pays: United States
ID NLM: 101521733
Informations de publication
Date de publication:
Aug 2020
Aug 2020
Historique:
received:
29
11
2019
revised:
23
02
2020
revised:
12
05
2020
accepted:
20
05
2020
entrez:
4
9
2020
pubmed:
4
9
2020
medline:
11
5
2021
Statut:
ppublish
Résumé
Team-based primary care has the potential to improve care delivery. However, residency scheduling and precepting models make creating functional ambulatory teams challenging. We describe the team-based care transformation at a large academic internal medicine residency practice. On July 1, 2016, the program transitioned to a 6+2 schedule and the clinic was divided into teams. Residents were precepted by 2 team preceptors, social work and care coordination needs were met by team-specific staff, and front desk staff were trained on maintaining primary care physician (PCP) and team continuity. Weekly team meetings provided opportunities for proactive patient and panel management, and preclinic huddles incorporated staff into team functions. Pre-transformation (June 2016) and post-transformation (June 2017) surveys were distributed to residents (n = 131), faculty (n = 14), and staff (n = 65) to assess team functioning. Patient-PCP continuity was monitored on a quarterly basis. Three hundred sixty-two of 420 surveys were returned (86%). The intervention was associated with significant improvements in resident satisfaction (from 3.05 baseline to 4.07 of 5, Team-based care was implemented with significant improvements in continuity and resident satisfaction and perceptions of teamwork; however, the impact on faculty and staff was limited.
Sections du résumé
BACKGROUND
BACKGROUND
Team-based primary care has the potential to improve care delivery. However, residency scheduling and precepting models make creating functional ambulatory teams challenging.
OBJECTIVE
OBJECTIVE
We describe the team-based care transformation at a large academic internal medicine residency practice.
METHODS
METHODS
On July 1, 2016, the program transitioned to a 6+2 schedule and the clinic was divided into teams. Residents were precepted by 2 team preceptors, social work and care coordination needs were met by team-specific staff, and front desk staff were trained on maintaining primary care physician (PCP) and team continuity. Weekly team meetings provided opportunities for proactive patient and panel management, and preclinic huddles incorporated staff into team functions. Pre-transformation (June 2016) and post-transformation (June 2017) surveys were distributed to residents (n = 131), faculty (n = 14), and staff (n = 65) to assess team functioning. Patient-PCP continuity was monitored on a quarterly basis.
RESULTS
RESULTS
Three hundred sixty-two of 420 surveys were returned (86%). The intervention was associated with significant improvements in resident satisfaction (from 3.05 baseline to 4.07 of 5,
CONCLUSIONS
CONCLUSIONS
Team-based care was implemented with significant improvements in continuity and resident satisfaction and perceptions of teamwork; however, the impact on faculty and staff was limited.
Identifiants
pubmed: 32879689
doi: 10.4300/JGME-D-19-00909.1
pmc: PMC7450747
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
478-484Informations de copyright
Accreditation Council for Graduate Medical Education 2020.
Déclaration de conflit d'intérêts
Conflict of interest: The authors declare they have no competing interests.
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