Clinic Design and Continuity in Internal Medicine Resident Clinics: Findings of the Educational Innovations Project Ambulatory Collaborative
| العنوان: | Clinic Design and Continuity in Internal Medicine Resident Clinics: Findings of the Educational Innovations Project Ambulatory Collaborative |
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| المؤلفون: | Christopher Nabors, Mark L. Wieland, Sean Drake, David B. Sweet, Michael Rosenblum, Amy Smith, Eric J. Warm, Katherine A. Julian, Mark L. Francis, Kris G. Thomas, Keri Lyn Gwisdalla, David A. Wininger, Andrew Varney, Maureen D. Francis, Anne G. Pereira |
| المصدر: | Journal of graduate medical education, vol 7, iss 1 |
| بيانات النشر: | Journal of Graduate Medical Education, 2015. |
| سنة النشر: | 2015 |
| مصطلحات موضوعية: | Male, Models, Educational, medicine.medical_specialty, Cross-sectional study, Workload, Ambulatory Care Facilities, Education, Nursing, Ambulatory care, Models, Clinical Research, Medical, Internal medicine, Ambulatory Care, Internal Medicine, medicine, Humans, Block model, Educational, Graduate, Original Research, Analysis of covariance, Multivariable linear regression, business.industry, Internship and Residency, General Medicine, Continuity of Patient Care, Health Services, United States, Cross-Sectional Studies, Good Health and Well Being, Education, Medical, Graduate, Facility Design and Construction, Family medicine, Ambulatory, Female, Continuity of care, Diffusion of Innovation, business, Curriculum and Pedagogy |
| الوصف: | Background Many internal medicine (IM) programs have reorganized their resident continuity clinics to improve trainees' ambulatory experience. Downstream effects on continuity of care and other clinical and educational metrics are unclear. Methods This multi-institutional, cross-sectional study included 713 IM residents from 12 programs. Continuity was measured using the usual provider of care method (UPC) and the continuity for physician method (PHY). Three clinic models (traditional, block, and combination) were compared using analysis of covariance. Multivariable linear regression analysis was used to analyze the effect of practice metrics and clinic model on continuity. Results UPC, reflecting continuity from the patient perspective, was significantly different, and was highest in the block model, midrange in combination model, and lowest in the traditional model programs. PHY, reflecting continuity from the perspective of the resident provider, was significantly lower in the block model than in combination and traditional programs. Panel size, ambulatory workload, utilization, number of clinics attended in the study period, and clinic model together accounted for 62% of the variation found in UPC and 26% of the variation found in PHY. Conclusions Clinic model appeared to have a significant effect on continuity measured from both the patient and resident perspectives. Continuity requires balance between provider availability and demand for services. Optimizing this balance to maximize resident education, and the health of the population served, will require consideration of relevant local factors and priorities in addition to the clinic model. |
| وصف الملف: | application/pdf |
| تدمد: | 1949-8357 1949-8349 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::e12146a5ce79edff7a67c2d5172e3056 https://doi.org/10.4300/jgme-d-14-00358.1 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....e12146a5ce79edff7a67c2d5172e3056 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 19498357 19498349 |
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