Change in Residents' Experience in Continuity Clinic After Patient-Focused Primary Care Redesign
| Autor: | Benjamin N. Fogel, Jonathan A. Finkelstein, Stephen Warrick, Melissa Klein |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
Adult
Male medicine.medical_specialty Quality management Attitude of Health Personnel health care facilities manpower and services media_common.quotation_subject education Primary care Affect (psychology) Pediatrics 03 medical and health sciences Young Adult 0302 clinical medicine Ambulatory care Nursing health services administration 030225 pediatrics Patient-Centered Care Ambulatory Care Medicine Humans 030212 general & internal medicine Young adult Cooperative Behavior health care economics and organizations media_common Quality of Health Care Response rate (survey) Teamwork Primary Health Care business.industry Internship and Residency Continuity of Patient Care Quality Improvement Family medicine Pediatrics Perinatology and Child Health Female business Patient centered |
| Zdroj: | Academic pediatrics. 16(7) |
| ISSN: | 1876-2867 |
| Popis: | Evaluation of efforts to redesign primary care has primarily focused on clinical services, with limited assessment of the effect on learners. This study evaluated the change in pediatric residents' perception of training, teamwork, and patient care in 2 different continuity clinic settings that were implementing patient-focused primary care redesign.Continuity clinic residents at 2 large urban pediatric training programs completed a survey, developed de novo, before and after primary care redesign. Differences in the proportion of positive (≥4 of 5) ratings before and after redesign were compared using chi-squared tests in 2 practice sites, each of which focused on improving specific aspects of their practice.The response rate was70% in both sites and in both years. Residents in the site focused on teamwork and continuity were more likely to report improved teamwork training (64% vs 83%; P .05) and teamwork among residents (82% vs 98%; P .05) after redesign. Perception of overall quality of care in clinic also improved (47% vs 68%; P .05). Residents in the site focused on clinic flow were more likely to report that physicians, nurses, and administrative staff worked together to optimize patient flow after redesign (25% vs 48%; P .05). No improvements were seen in domains without focused interventions in either site.Practice redesign focused on clinical outcomes can positively affect resident perception of their training and clinical experience in continuity clinic. Future redesign efforts deliberately involving residents might further enhance continuity clinic training. |
| Databáze: | OpenAIRE |
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