Abstract
This article was migrated. The article was not marked as recommended. BackgroundProviding direct feedback on the quality of residents' continuity clinic is particularly a challenge for large multisite residencies when parent institutions are at different stages of reporting and use different electronic health records. Without this level of feedback on the quality of their outpatient practice, residents may be ill-equipped to succeed in the value based reimbursement environments they will likely encounter post graduation.ObjectiveThe authors report on a self assessment tool designed to provide value based feedback and direct individualized quality improvement in resident continuity clinic practices across four sites of a large internal medicine residency program. MethodResidents were introduced to a quality reporting tool that they used to self report patient-care metrics throughout their residency. For three years including the academic years ending 2014, 2015 and 2016 a "report card" was provided to each resident and a self assessment done by the resident of their individual quality metrics. The residents used this information to develop team based QI projects to implement in the upcoming year. ResultsOver the three year reporting period 257 of 365 possible surveys were completed for an overall response rate of 70.4%. The number of surveys completed per resident per year varied from 0 to 65. Resident clinic data suggested that quality metrics exceeded national standards in several domains. Opportunities for improvement were found and used to direct quality improvement projects.ConclusionAssessing quality of outpatient medicine practice is an important and easily attainable goal in a resident continuity clinic practice setting.
Highlights
Models of care such as a patient centered medical home (PCMH) or an Accountable Care Organization (ACO) offer hope of lowered cost and improved patient care quality. [D’Aunno (2016), Strange (2010), Jackson (2013)] While uncertainly presently exists about the security of the Affordable Care Act (ACA) or of MACRA it is likely that most practices will continue to enter reimbursement agreements subject to quality reporting under the MIPS (Merit Based Incentive Payment System) or APM.One of the goals of residency education is to prepare residents for the environment they will practice in
Providing direct feedback on the quality of residents’ continuity clinic is a challenge for large multisite residencies when parent institutions are at different stages of reporting and use different electronic health records
Educating residents to function effectively in surroundings that are at different stages of quality reporting and that use different electronic medical records is a particular challenge for large multi-site training programs
Summary
Providing direct feedback on the quality of residents’ continuity clinic is a challenge for large multisite residencies when parent institutions are at different stages of reporting and use different electronic health records. Without this level of feedback on the quality of their outpatient practice, residents may be ill-equipped to succeed in the value based reimbursement environments they will likely encounter post graduation
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