Teaching Residents About Continuity of Care
-
Upload
cain-cardenas -
Category
Documents
-
view
34 -
download
1
description
Transcript of Teaching Residents About Continuity of Care
![Page 1: Teaching Residents About Continuity of Care](https://reader035.fdocuments.us/reader035/viewer/2022062304/5681389b550346895da04cbb/html5/thumbnails/1.jpg)
Teaching Residents About Continuity of Care
Queen’s University Health Sciences Education Rounds
November 15, 2007
Dr. Karen Schultz
![Page 2: Teaching Residents About Continuity of Care](https://reader035.fdocuments.us/reader035/viewer/2022062304/5681389b550346895da04cbb/html5/thumbnails/2.jpg)
Overview
Why teach this? Why change? Process to making changes What we did How we’re going to evaluate it
![Page 3: Teaching Residents About Continuity of Care](https://reader035.fdocuments.us/reader035/viewer/2022062304/5681389b550346895da04cbb/html5/thumbnails/3.jpg)
Why even teach this or What’s so important about continuity of care?
Increased patient satisfaction Improved patient outcomes Increased physician satisfaction
![Page 4: Teaching Residents About Continuity of Care](https://reader035.fdocuments.us/reader035/viewer/2022062304/5681389b550346895da04cbb/html5/thumbnails/4.jpg)
Why Change?
Continuity of care is good=the carrot
Because we were told we had to=the stick!
![Page 5: Teaching Residents About Continuity of Care](https://reader035.fdocuments.us/reader035/viewer/2022062304/5681389b550346895da04cbb/html5/thumbnails/5.jpg)
What we had been doing
4 months in first year 4 months in second year—often 2 x 2
![Page 6: Teaching Residents About Continuity of Care](https://reader035.fdocuments.us/reader035/viewer/2022062304/5681389b550346895da04cbb/html5/thumbnails/6.jpg)
What many other FM programs do ½ day back
![Page 7: Teaching Residents About Continuity of Care](https://reader035.fdocuments.us/reader035/viewer/2022062304/5681389b550346895da04cbb/html5/thumbnails/7.jpg)
Queen’s and the ½ day back
Evidence? Set up of the program
![Page 8: Teaching Residents About Continuity of Care](https://reader035.fdocuments.us/reader035/viewer/2022062304/5681389b550346895da04cbb/html5/thumbnails/8.jpg)
Queen’s Family Medicine Rotation Sites
![Page 9: Teaching Residents About Continuity of Care](https://reader035.fdocuments.us/reader035/viewer/2022062304/5681389b550346895da04cbb/html5/thumbnails/9.jpg)
Queen’s and the ½ day back
1=Evidence? 2=Set up of the program 3=Community rotations’ continuity of care 4=Residents’ reluctance
1+2+3+4=concern
![Page 10: Teaching Residents About Continuity of Care](https://reader035.fdocuments.us/reader035/viewer/2022062304/5681389b550346895da04cbb/html5/thumbnails/10.jpg)
Change. Oh so easy. Not!! “Things change only when people change” Buy in
– “Change is difficult but often essential to survival” “Change can be the rule but not the ruler”
– Informed– ++ consensus building (ideas, brainstorm difficulties, solutions from
within, not imposed…)• Working group• Rounds• Emails• Surveys
Pilotevaluationchangesprogram roll out Evaluate Feedback
![Page 11: Teaching Residents About Continuity of Care](https://reader035.fdocuments.us/reader035/viewer/2022062304/5681389b550346895da04cbb/html5/thumbnails/11.jpg)
What we are doing
Continuity of care clinics– ~10 patients/resident
• Deliberate selection of pts
– Clinic ~ every 2 months (minimum)• Deliberate timing
– 1-3 years
![Page 12: Teaching Residents About Continuity of Care](https://reader035.fdocuments.us/reader035/viewer/2022062304/5681389b550346895da04cbb/html5/thumbnails/12.jpg)
Evaluation
1. Impact:– Surveys of all involved– Patients, staff (receptionists, nurses, doctors),
residents
2. Is it achieving it’s educational objective? Did they get “IT”? How to measure “IT”?
![Page 13: Teaching Residents About Continuity of Care](https://reader035.fdocuments.us/reader035/viewer/2022062304/5681389b550346895da04cbb/html5/thumbnails/13.jpg)
RESEARCH!!
![Page 14: Teaching Residents About Continuity of Care](https://reader035.fdocuments.us/reader035/viewer/2022062304/5681389b550346895da04cbb/html5/thumbnails/14.jpg)
Literature review
Types of continuity of care– Longitudinal, informational, geographic,
multidisciplinary, interpersonal. Interpersonal continuity of care
– Patients—patient satisfaction surveys– Health care provider
Literature review IP C of C HCP=responsibility
Informal discussions
![Page 15: Teaching Residents About Continuity of Care](https://reader035.fdocuments.us/reader035/viewer/2022062304/5681389b550346895da04cbb/html5/thumbnails/15.jpg)
The Grand Plan
Objective: evaluate this change to our educational program
Step 1=gain an understanding of IP C of C from the doctors perspective
Step 2=take key concepts from 1, create a survey
Step 3=assess different ways of teaching about continuity of care
Step 4=save the world
![Page 16: Teaching Residents About Continuity of Care](https://reader035.fdocuments.us/reader035/viewer/2022062304/5681389b550346895da04cbb/html5/thumbnails/16.jpg)
Step 1: What are the components of IP C of C for the HC provider? Qualitative research What do I know of qualitative research?
![Page 17: Teaching Residents About Continuity of Care](https://reader035.fdocuments.us/reader035/viewer/2022062304/5681389b550346895da04cbb/html5/thumbnails/17.jpg)
The steps to step 1
Reading Conferences
– Workshops– Listening to others, looking at posters
Colleagues Networking
![Page 18: Teaching Residents About Continuity of Care](https://reader035.fdocuments.us/reader035/viewer/2022062304/5681389b550346895da04cbb/html5/thumbnails/18.jpg)
What I’ve learned
Different types of qualitative research– Focus groups
Bias issues– Triangulate data– Saturation– Member checking
Get a grant (or typing a transcript hurts!) Work with a colleague
![Page 19: Teaching Residents About Continuity of Care](https://reader035.fdocuments.us/reader035/viewer/2022062304/5681389b550346895da04cbb/html5/thumbnails/19.jpg)
Step 2: the Survey
Quantitative research What do I know of quantitative research?
![Page 20: Teaching Residents About Continuity of Care](https://reader035.fdocuments.us/reader035/viewer/2022062304/5681389b550346895da04cbb/html5/thumbnails/20.jpg)
With a little help from Gary Larson
What We Say To Dogs "Okay, Ginger! I've had it! You stay out of the garbage! Understand, Ginger? Stay out of the garbage, or else!"What They Hear"blah blah GINGER blah blah blah blah blah blah blah blah GINGER blah blah blah blah blah..."
My understanding of Quantitative research
![Page 21: Teaching Residents About Continuity of Care](https://reader035.fdocuments.us/reader035/viewer/2022062304/5681389b550346895da04cbb/html5/thumbnails/21.jpg)
What I’ve learned so far
Get a stats degree Collaborate
![Page 22: Teaching Residents About Continuity of Care](https://reader035.fdocuments.us/reader035/viewer/2022062304/5681389b550346895da04cbb/html5/thumbnails/22.jpg)
Discussion
Collaborating– Across disciplines
Getting grants in medical education ??