Document Detail


Ambulatory office organization for internal medicine resident medical education.
MedLine Citation:
PMID:  20978423     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: Residents will most effectively learn about ambulatory, systems-based practice by working in highly functional ambulatory practices; however, systems experiences in ambulatory training are thought to be highly variable. The authors sought to determine the prevalence of functional-practice characteristics at clinics where residents learn.
METHOD: In 2007, the authors conducted a national survey of medical directors of resident continuity clinics using a comprehensive, Web-based instrument that included both a residency clinic assessment and a practice system assessment (PSA). The authors designed the PSA to estimate the Physician Practice Connections (PPC) score, indicating the readiness of a practice to function as a patient-centered medical home (PCMH).
RESULTS: Of 356 clinic directors or physician representatives responding to an initial inquiry, 221 completed the survey (62%)--representing 185 programs (49% of accredited programs). The majority of clinics were hospital based (139/220; 63%) or hospital supported (41/220; 19%) and were located in urban settings (151/217; 70%). Estimated payer mix categories included Medicare or managed Medicare (169; 29%), Medicaid or managed Medicaid (161; 34%), and self-pay (156; 25%). The mean estimated PPC score was 53 points (of 100; SD = 17.6). Suburban and rural clinics, Veterans Affairs' clinics, federally qualified health centers, and clinics with a higher proportion of patients with commercial insurance or managed Medicare earned higher scores.
CONCLUSIONS: A substantial portion of residency clinics have elements needed for PCMH recognition. However, clinics struggled with connecting these elements with coordination-of-care processes, suggesting areas for improvement to support better functioning of ambulatory training practices.
Authors:
Stewart F Babbott; Brent W Beasley; Siddharta Reddy; F Daniel Duffy; Mohan Nadkarni; Eric S Holmboe
Related Documents :
18777823 - The importance of fluid balance in clinical practice.
21607233 - The society for acute medicine (uk) acute medicine training survey 2007.
8721223 - New records of tabanidae (diptera) from saudi arabia, first record of atylotus venturii...
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Academic medicine : journal of the Association of American Medical Colleges     Volume:  85     ISSN:  1938-808X     ISO Abbreviation:  Acad Med     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-11-25     Completed Date:  2011-01-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8904605     Medline TA:  Acad Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1880-7     Citation Subset:  AIM; IM    
Affiliation:
Division of General and Geriatric Medicine, Department of Medicine, University of Kansas, Kansas City, Kansas 66160, USA. sbabbott@kumc.edu
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Ambulatory Care / organization & administration*
Humans
Internal Medicine / education*
Internship and Residency / standards*
Specialization*
United States

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Benefits and costs of pay for performance as perceived by residents: a qualitative study.
Next Document:  Creating an academy of clinical excellence at Johns Hopkins Bayview Medical Center: a 3-year experie...