We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Multiyear Outcomes of a Population-Oriented Care Redesign in an Internal Medicine Residency Continuity Clinic.
- Authors
Cho, Alex H.; Namdari, Natasha T.; Bowlby, Lynn; Zipkin, Daniella A.; Greenblatt, Lawrence; Causey, Holly E.; Dillard, Jan M.; Ross, Adia K.; Pendergast, Jane; Boulware, L. Ebony
- Abstract
The cornerstone of ambulatory care training for internal medicine residents is the continuity clinic, which often serves medically and psychosocially complex patients. We conducted and evaluated a population-oriented redesign to improve care for "high-needs" patients and the resident experience at a hospital-based safety net primary care internal medicine practice in the Southeastern U.S. A Define, Measure, Analyze, Implement, Control (DMAIC) framework was adapted to identify and develop three main interventions to address major unmet needs of patients and trainees: (1) a behavioral health-focused team care model; (2) a formalized hospital discharge transitions workflow; and (3) the creation of larger "firms" of smaller resident practice partnerships. We constructed a financial model to justify investments, with metrics to track progress. Over three years, sustained reductions in hospitalizations and ED visits (mean annual changes of –11.6% and –16.9%, respectively) were achieved. Resident primary care provider (PCP)-to-patient continuity and satisfaction also improved. [End Page 724]
- Subjects
SOUTHERN States; INTERNAL medicine; INTERNSHIP programs; EVALUATION of medical care; MEDICAL needs assessment; MEDICAL education; PRIMARY health care; POPULATION health; HUMAN services programs
- Publication
Journal of Health Care for the Poor & Underserved, 2020, Vol 31, Issue 2, p724
- ISSN
1049-2089
- Publication type
Article
- DOI
10.1353/hpu.2020.0057