scholarly journals The Residency Performance Index: An Effort at Residency Quality Assessment and Improvement in Family Medicine

2014 ◽  
Vol 6 (4) ◽  
pp. 756-759 ◽  
Author(s):  
Grant S. Hoekzema ◽  
Lisa Maxwell ◽  
Joseph W. Gravel ◽  
Walter W. Mills ◽  
William Geiger
Keyword(s):  
Quality Improvement ◽  
Family Medicine ◽  
Performance Index ◽  
Program Improvement ◽  
First Year ◽  
Clinical Experiences ◽  
Residency Programs ◽  
Family Medicine Residency ◽  
Lack Of Information ◽  
Quality Improvement Tool

Abstract Background Residency programs are increasingly being asked to defend their quality, and that of the residents they produce. Yet “residency quality” is a construct that has not been well defined, with no accepted standards other than meeting accreditation standards. In 2009, the Association of Family Medicine Residency Directors developed a strategic plan that included the goal of raising the quality of family medicine training. Objective We describe the development of this quality improvement tool, which we called the residency performance index (RPI), and its first year of use by family medicine residency programs. We describe the use of the tool as a “dashboard” to facilitate program self-improvement. Intervention Using program metrics specific to family medicine training, and benchmark criteria for these metrics, the RPI was launched in 2012 to help programs identify strengths and areas for improvement in their educational activities and resident clinical experiences that could be tracked and reviewed as part of the annual program evaluation. Results Approximately 100 program directors began using the tool and 70 finished the process, and were provided aggregate data. Initial review of this experience revealed difficulties with collecting data, and lack of information on graduates' scope of practice. It also showed the potential usefulness of the tool as a program improvement mechanism. Conclusions The RPI is a new quality improvement tool for family medicine residency programs. Although some initial challenges need to be addressed, it has the promise to aid family medicine residency in its internal improvement efforts.

scholarly journals Education in Quality Improvement for Practice in Primary Care During Residency Training and Subsequent Activities in Practice

2014 ◽  
Vol 6 (1) ◽  
pp. 50-54 ◽  
Author(s):  
Peter J. Carek ◽  
Lori M. Dickerson ◽  
Michele Stanek ◽  
Charles Carter ◽  
Mark T. Godenick ◽  
...  
Keyword(s):  
South Carolina ◽  
Quality Improvement ◽  
Family Medicine ◽  
Patient Care ◽  
Patient Centered ◽  
Residency Programs ◽  
Family Medicine Residency ◽  
The Family ◽  
The Impact ◽  
Standardized Curriculum

Abstract Background Quality improvement (QI) is an integral aspect of graduate medical education and an important competence for physicians. Objective We examined the QI activities of recent family medicine residency graduates and whether a standardized curriculum in QI during residency resulted in greater self-reported participation in QI activities in practice after graduation. Methods The family medicine residency programs affiliated with the South Carolina Area Health Education Consortium (N  =  7) were invited to participate in this study. Following completion of introductory educational activities, each site implemented regularly occurring (at least monthly) educational and patient care activities using QI principles and tools. Semiannually, representatives from each participating site met to review project aims and to provide updates regarding the QI activities in their program. To examine the impact of this project on QI activities, we surveyed graduates from participating programs from the year prior to and 2 years after the implementation of the curriculum. Results Graduates in the preimplementation and postimplementation cohorts reported participating in periodic patient care data review, patient care registries, QI projects, and disease-specific activities (57%–71% and 54%–63%, respectively). There were no significant differences in QI activities between the 2 groups except in activities associated with status of their practice as a patient-centered medical home. Conclusions Most but not all family medicine graduates reported they were actively involved in QI activities within their practices, independent of their exposure to a QI curriculum during training.

scholarly journals Meaningful Partnerships: Stages of Development of a Patient and Family Advisory Council at a Family Medicine Residency Clinic (Preprint)

2018 ◽  
Author(s):  
Jeffrey D Schlaudecker ◽  
Keesha Goodnow ◽  
Anna Goroncy ◽  
Reid Hartmann ◽  
Saundra Regan ◽  
...  
Keyword(s):  
Family Medicine ◽  
Residency Training Program ◽  
Lessons Learned ◽  
Advisory Council ◽  
First Year ◽  
Residency Programs ◽  
Family Medicine Residency ◽  
Working Together ◽  
The Creation ◽  
Improve Health

BACKGROUND Partnering with patients and families is a crucial step in optimizing health. A patient and family advisory council (PFAC) is a group of patients and family members working together collaboratively with providers and staff to improve health care. OBJECTIVE This study aimed to describe the creation of a PFAC within a family medicine residency clinic. To understand the successful development of a PFAC, challenges, potential barriers, and positive outcomes of a meaningful partnership will be reported. METHODS The stages of PFAC development include leadership team formation and initial training, PFAC member recruitment, and meeting launch. Following a description of each stage, outcomes are outlined and lessons learned are discussed. PFAC members completed an open-ended survey and participated in a focus group interview at the completion of the first year. Interviewees provided feedback regarding (1) favorite aspects or experiences, (2) PFAC impact on a family medicine clinic, and (3) future projects to improve care. Common themes will be presented. RESULTS The composition of the PFAC consisted of 18 advisors, including 8 patient and family advisors, 4 staff advisors, 4 resident physician advisors, and 2 faculty physician advisors. The average meeting attendance was 12 members over 11 meetings in the span of the first year. A total of 13 out of 13 (100%) surveyed participants were satisfied with their experience serving on the PFAC. CONCLUSIONS PFACs provide a platform for patient engagement and an opportunity to drive home key concepts around collaboration within a residency training program. A framework for the creation of a PFAC, along with lessons learned, can be utilized to advise other residency programs in developing and evaluating meaningful PFACs.

scholarly journals Education and Attitudes on Medical Cannabis in Family Medicine Residency Programs

2020 ◽  
Vol 52 (10) ◽  
pp. 730-735
Author(s):  
Ann M. Philbrick ◽  
Christine Danner ◽  
Abayomi Oyenuga ◽  
Chrystian Pereira ◽  
Jason Ricco ◽  
...  
Keyword(s):  
United States ◽  
Family Medicine ◽  
The United States ◽  
Clinical Experiences ◽  
Medical Cannabis ◽  
Residency Programs ◽  
Family Medicine Residency ◽  
Medicine Resident ◽  
Current State ◽  
Research Alliance

Background and Objectives: Medical cannabis has become increasingly prevalent in the United States, however the extent of family medicine resident education on this topic remains unknown. The objective of this study was to ascertain the current state of medical cannabis education across this population and identify patterns in education based on state legality and program director (PD) practices. Methods: Survey questions were part of the Council of Academic Family Medicine Educational Research Alliance (CERA) omnibus survey from May 2019 to July 2019. PDs from all Accreditation Council for Graduate Medical Education (ACGME)-accredited US family medicine residency programs received survey invitations by email. Results: A total of 251 (40.7%) PDs responded, with 209 (83.6% [209/250]) reporting at least 1 hour of didactic curriculum regarding cannabis. The most common context was substance misuse (mean 3.0±4.1 hours per 3 years), followed by pain management (2.7±3.4 hours), and management of other conditions (2.1±2.7 hours). Thirty-eight programs (15.2% [38/250]) offered clinical experiences related to medical cannabis, and PDs who had previously prescribed or recommended medical cannabis were more likely to offer this experience (P<.0001). Experiences peaked after 3 to 5 years of medical cannabis legality. PD confidence in resident counseling skills was low overall, but did increase among programs with clinical experiences (P=.0033). Conclusions: The current trajectory of medical cannabis use in the United States makes it likely that residents will care for patients interested in medical cannabis, therefore it is important residents be prepared to address this reality. Opportunities exist for improving medical cannabis education in family medicine residency programs.

scholarly journals Six Years’ Experience Using Specialty National Residency Index: An Early Dashboard to Document Change Over Time

2021 ◽  
Vol 53 (1) ◽  
pp. 39-47
Author(s):  
Grant S. Hoekzema ◽  
Walter Mills ◽  
Lisa Maxwell ◽  
Joseph W. Gravel ◽  
James David Honeycutt
Keyword(s):  
Quality Improvement ◽  
Family Medicine ◽  
Linear Regression Analysis ◽  
National Level ◽  
Lessons Learned ◽  
Scope Of Practice ◽  
Aggregated Data ◽  
Residency Programs ◽  
Family Medicine Residency ◽  
Over Time

Background and Objectives: A decade ago, the Association of Family Medicine Residency Directors developed the Residency Performance Index (RPI) as a novel dashboard of metrics to support residency programs’ quality improvement efforts. Although the RPI has since been discontinued, we sought to identify lessons learned from an analysis of 6 years of data collected while the RPI was in use to inform future quality and accreditation efforts implemented at the national level. Methods: The RPI collected data from 2012-2017 for nearly 250 distinct family medicine residency programs, identifying strengths and areas for improvement. Eighty-two programs provided data for 3 or more years of measures allowing analysis of improvement trends. Results: For participating programs, aggregate data over 6 years indicated the majority had stable leadership and accreditation. Total family medicine center (FMC) visits by graduates and resident visit demographics were robust. Graduate scope of practice was consistent with nationally publicized trends. Programs hit most aspirational targets more than 40% of the time. However, analysis for those programs with 3 or more years of data revealed that the tool did not result in significant changes for most metrics. Linear regression analysis showed improvements in total patient visits, visits under 10 years of age, and certain procedural competencies for those programs with 3 or more years of data. Conclusions: The RPI was the first and only nationally utilized family medicine graduate medical education quality improvement tool. Individual programs did not show substantial change in quantifiable metrics over time despite limited evidence of select programmatic improvements. Nationally, aggregated data provided insight into scope of practice and other areas of interest in residency training. Further efforts in provision of residency improvement tools are important to support programs given the increasing complexity and high stakes of family medicine residency education.

scholarly journals Maternity Care Tracks at US Family Medicine Residency Programs

2021 ◽  
Vol 53 (10) ◽  
pp. 857-863
Author(s):  
Steven E. Roskos ◽  
Tyler W. Barreto ◽  
Julie P. Phillips ◽  
Valerie J. King ◽  
W. Suzanne Eidson-Ton ◽  
...  
Keyword(s):  
Family Medicine ◽  
Maternity Care ◽  
Underserved Populations ◽  
Residency Programs ◽  
Family Medicine Residency ◽  
Survey Response Rate ◽  
Care Training ◽  
Practice Methods ◽  
Residency Program Directors ◽  
The Relationship

Background and Objectives: The number of family physicians providing maternity care continues to decline, jeopardizing access to needed care for underserved populations. Accreditation changes in 2014 provided an opportunity to create family medicine residency maternity care tracks, providing comprehensive maternity care training only for interested residents. We examined the relationship between maternity care tracks and residents’ educational experiences and postgraduate practice. Methods: We included questions on maternity care tracks in an omnibus survey of family medicine residency program directors (PDs). We divided respondent programs into three categories: “Track,” “No Track Needed,” and “No Track.” We compared these program types by their characteristics, number of resident deliveries, and number of graduates practicing maternity care. Results: The survey response rate was 40%. Of the responding PDs, 79 (32%) represented Track programs, 55 (22%) No Track Needed programs, and 94 (38%) No Track programs. Residents in a track attended more deliveries than those not in a track (at Track programs) and those at No Track Needed and No Track programs. No Track Needed programs reported the highest proportion of graduates accepting positions providing inpatient maternity care in 2019 (21%), followed by Track programs (17%) and No Track programs (5%; P<.001). Conclusions: Where universal robust maternity care education is not feasible, maternity care tracks are an excellent alternative to provide maternity care training and produce graduates who will practice maternity care. Programs that cannot offer adequate experience to achieve competence in inpatient maternity care may consider instituting a maternity care track.

scholarly journals Residency Setting Association With Resident Substance Use Disorder Training: A CERA Secondary Data Analysis

2020 ◽  
Vol 52 (3) ◽  
pp. 198-201
Author(s):  
Joshua St. Louis ◽  
Emma Worringer ◽  
Wendy B. Barr
Keyword(s):  
Substance Use ◽  
Family Medicine ◽  
Residency Program ◽  
Secondary Analysis ◽  
Secondary Data ◽  
The United States ◽  
Resident Training ◽  
Addiction Medicine ◽  
Residency Programs ◽  
Family Medicine Residency

Background and Objectives: As the opioid crisis worsens across the United States, the factors that impact physician training in management of substance use disorders become more relevant. A thorough understanding of these factors is necessary for family medicine residency programs to inform their own residency curricula. The objective of our study was to identify factors that correlate with increased residency training in addiction medicine across a broad sample of family medicine residencies. Methods: We performed secondary analysis of a national family medicine residency program director survey conducted in 2015-2016 (CERA Survey PD-8). We obtained data from the Council of Academic Family Medicine Educational Research Alliance (CERA) Data Clearinghouse. We analyzed residency clinic site designation as a patient-centered medical home (PCMH), federally-qualified health center (FQHC), or both, for their correlation with faculty member possession of DEA-X buprenorphine waiver license, as well as required residency curriculum in addiction medicine. Results: Residency programs situated in an FQHC were more likely to have faculty members who possessed DEA-X buprenorphine waiver licenses (P=.025). Residency clinics that were both a PCMH as well as an FQHC also correlated strongly (P=.001). Furthermore, residencies with faculty who possessed a DEA-X license were significantly more likely to have a required curriculum in addiction medicine (P=.002). Conclusions: Our quantitative secondary analysis of CERA survey data of family medicine residency program directors revealed that resident training in addiction medicine is strongly correlated with both residency clinic setting (FQHC or FQHC/PCMH) as well as residency faculty possession of DEA-X licenses.

Annual block scheduling for family medicine residency programs with continuity clinic considerations

2016 ◽  
Vol 48 (9) ◽  
pp. 797-811 ◽  
Author(s):  
Jonathan F. Bard ◽  
Zhichao Shu ◽  
Douglas J. Morrice ◽  
Luci K. Leykum ◽  
Ramin Poursani
Keyword(s):  
Family Medicine ◽  
Block Scheduling ◽  
Continuity Clinic ◽  
Residency Programs ◽  
Family Medicine Residency
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