scholarly journals Motivating residents to change communication: the role of a brief motivational interviewing didactic

2019 ◽  
Vol 20 ◽  
Author(s):  
Lisa Renee Miller-Matero ◽  
Erin T. Tobin ◽  
Elizabeth Fleagle ◽  
Joseph P. Coleman ◽  
Anupama Nair
Keyword(s):  
Motivational Interviewing ◽  
Medical Home ◽  
Training Programs ◽  
Patient Centered Medical Home ◽  
Patient Centered ◽  
Residency Programs ◽  
Change Communication ◽  
Post Test

Abstract Introduction: Motivational interviewing (MI) is a patient-centered approach that encourages patients to change behaviors. MI training programs have increased residents’ knowledge and use of MI skills; however, many residency programs may not have the time to dedicate to lengthy MI programs. The purpose of this study was to evaluate the benefits of a brief MI didactic for residents in an academic internal medicine patient-centered medical home. Methods: Thirty-two residents completed a 1-h MI training between October 2016 and June 2017 and completed measures on their knowledge of, confidence using, and utilization of MI skills prior to the training, immediately after the training, and at a 1-month follow-up. Results: The residents’ knowledge of and confidence using MI skills increased from pre-test to post-test and also increased from pre-test to the 1-month follow-up. Conclusion: The utilization of MI skills increased from pre-test to the 1-month follow-up. A 1-h didactic offers benefits to residents.

Retention: Building a Patient-Centered Medical Home in HIV Primary Care through PUFF (Patients Unable to Follow-up Found)

2012 ◽  
Vol 23 (3A) ◽  
pp. 81-95 ◽  
Author(s):  
Amy M. Sitapati ◽  
Jan Limneos ◽  
Militza Bonet-Vázquez ◽  
Moira Mar-Tang ◽  
Huifang Qin ◽  
...  
Keyword(s):  
Primary Care ◽  
Medical Home ◽  
Patient Centered Medical Home ◽  
Patient Centered ◽  
Hiv Primary Care

scholarly journals Evaluation of liver test abnormalities in a patient-centered medical home: do liver test patterns matter?

2018 ◽  
Vol 66 (8) ◽  
pp. 1118-1123 ◽  
Author(s):  
Andrew D Schreiner ◽  
William P Moran ◽  
Jingwen Zhang ◽  
Elizabeth B Kirkland ◽  
Marc E Heincelman ◽  
...  
Keyword(s):  
Primary Care ◽  
Medical Home ◽  
Patient Centered Medical Home ◽  
Patient Centered ◽  
Repeat Testing ◽  
Liver Test ◽  
Clinical Patterns ◽  
Multiple Abnormalities ◽  
Liver Tests

Abnormal liver tests are extremely common in clinical practice, present with varying patterns and degrees of elevation, and can signal liver injury from a variety of causes. Responding to these abnormalities requires complex medical decision-making and merits investigation in primary care. This retrospective study investigates the association of patterns of liver test abnormality with follow-up in primary care. Using administrative data, this study includes patients with abnormal liver tests seen between 2007 and 2016 in a patient-centered medical home. Liver tests examined include serum bilirubin, aspartate aminotransferase, alanine aminotransferase, and alkaline phosphatase. Patients entered the cohort on the first liver test elevation. The outcome examined was completion of repeat testing, and the proportions of patients without follow-up were compared by patterns of index abnormality. 9545 patients met the inclusion criteria. Of these, 6155 (64.5%) possessed one liver test abnormality and 3390 (35.5%) possessed multiple abnormalities on index testing. Overall 1119 (11.7%) patients did not have repeat testing performed during the study period. A greater proportion of patients with lone abnormalities lacked repeat testing compared with those patients with multiple abnormalities. Differences in repeat testing appeared when comparing clinical patterns of abnormality, with higher proportions of follow-up in patients with testing suggestive of cholestasis. Over 11% of patients with abnormal liver tests did not undergo repeat testing during the study period. Repeat testing occurred more often in patients with multiple abnormalities and in clinical patterns suggestive of cholestasis. This study highlights a potential opportunity to improve quality of care.

scholarly journals Patient-Centered Medical Home Status and Preparedness to Assess Resident Milestones

PRiMER ◽  
2018 ◽  
Vol 2 ◽  
Author(s):  
Thad Wilkins ◽  
Wonsuk Yoo ◽  
Ralph A. Gillies ◽  
Julie Dahl-Smith ◽  
Jacqueline Dubose ◽  
...  
Keyword(s):  
Family Medicine ◽  
Medical Home ◽  
Health Behavior Change ◽  
Patient Centered Medical Home ◽  
National Council ◽  
Training Methods ◽  
Patient Centered ◽  
Residency Programs ◽  
Reducing Costs ◽  
Research Alliance

Purpose: The patient-centered medical home (PCMH) model has been proposed as the ideal model for delivering primary care and is focused on improving patient safety and quality, reducing costs, and enhancing patient satisfaction. The mandated Accreditation Council for Graduate Medical Education educational milestones for evaluation of resident competency represent the skills graduates will utilize after graduation. Many of these skills are reflected in the PCMH model. We sought to determine if residency programs whose main family medicine (FM) practice sites have achieved PCMH recognition are therefore more prepared to evaluate milestones. Method: A national Council of Academic Family Medicine Educational Research Alliance (CERA) survey of family medicine program directors (PDs) was conducted during June and July 2015 to determine if PCMH recognition influences PDs’ ability to evaluate training methods and their level of preparedness to evaluate milestones. Results: The response rate for the survey was 53.3% (252/473). Nearly two-thirds of the PDs (62.7%) reported that their main FM practice site had earned PCMH recognition. There was no statistical difference between non-PCMH-recognized vs PCMH-recognized programs in how PDs perceived that their program was prepared to assess residents’ milestone levels overall (P=0.414). Residents of PCMH-recognized programs were more likely to receive training for team-based care (P=0.009), system improvement plans (P<0.001), root-cause analysis (P=0.002), and health behavior change (P=0.003). Conclusions: PCMH recognition itself did not improve preparedness of FM residency programs to assess milestones. Residents from programs whose main FM practice site is PCMH-recognized are more likely to be trained in the key concepts and tasks associated with the PCMH model, tools that they are expected to utilize extensively after graduation.

The Role of the Registered Dietitian in the Patient-Centered Medical Home

2014 ◽  
Vol 29 (3) ◽  
pp. 201-209
Author(s):  
Shannon Gregg ◽  
Deborah Cohen ◽  
Jean Cerami ◽  
Carole A. Conn
Keyword(s):  
Medical Home ◽  
Patient Centered Medical Home ◽  
Registered Dietitian ◽  
Patient Centered

scholarly journals Assessing the Impact of Innovative Training of Family Physicians for the Patient-Centered Medical Home

2012 ◽  
Vol 4 (1) ◽  
pp. 16-22 ◽  
Author(s):  
Patricia A. Carney ◽  
M. Patrice Eiff ◽  
John W. Saultz ◽  
Erik Lindbloom ◽  
Elaine Waller ◽  
...  
Keyword(s):  
Medical School ◽  
Electronic Health Record ◽  
Medical Home ◽  
The United States ◽  
Health Centers ◽  
Health Record ◽  
Patient Centered Medical Home ◽  
Patient Centered ◽  
Residency Programs ◽  
Electronic Health

Abstract Background New approaches to enhance access in primary care necessitate change in the model for residency education. Purpose To describe instrument design, development and testing, and data collection strategies for residency programs, continuity clinics, residents, and program graduates participating in the Preparing the Personal Physician for Practice (P4) project. Methods We developed and pilot-tested surveys to assess demographic characteristics of residents, clinical and operational features of the continuity clinics and educational programs, and attitudes about and implementation status of Patient Centered Medical Home (PCMH) characteristics. Surveys were administered annually to P4 residency programs since the project started in 2007. Descriptive statistics were used to profile data from the P4 baseline year. Results Most P4 residents were non-Hispanic white women (60.7%), married or partnered, attended medical school in the United States and were the first physicians in their families to attend medical school. Nearly 85% of residency continuity clinics were family health centers, and about 8% were federally qualified health centers. The most likely PCMH features in continuity clinics were having an electronic health record and having fully secure remote access available; both of which were found in more than 50% of continuity clinics. Approximately one-half of continuity clinics used the electronic health record for safety projects, and nearly 60% used it for quality-improvement projects. Conclusions We created a collaborative evaluation model in all 14 P4 residencies. Successful implementation of new surveys revealed important baseline features of residencies and residents that are pertinent to studying the effects of new training models for the PCMH.

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