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Continuity of Care in Residency Teaching Practices: Lessons from Bright Spots

机译:住院医师教学实践中护理的连续性:亮点的教训

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摘要

Continuity of care is a challenge in primary care residency teaching clinics. Resident physicians have competing inpatient and outpatient responsibilities and often spend only 1 to 2 half-days per week in the clinic. Their clinic schedules are often pieced together after the needs of inpatient and specialty rotations are met. Similarly, faculty clinicians often balance limited clinic time with teaching, research, or administrative responsibilities. Seeking approaches to improve continuity of care, we visited 23 internal medicine, family medicine, and pediatric residency clinics across the US. This article highlights strategies to optimize continuity of care pioneered by 3 “bright spot” residency teaching clinics with high-continuity performance. The strategies include adopting a strong continuity culture and patient scheduling algorithms that prioritize continuity, appointing a team continuity anchor, and/or reorganizing resident and faculty schedules to maximize continuity. We hope that these perspectives can assist residency teaching practices to improve continuity of care for their patients.
机译:在基层住院医师教学诊所中,持续护理是一项挑战。住院医师承担着住院和门诊病人相互竞争的职责,并且通常每周在诊所仅花费1-2个半天。他们的临床时间表通常在满足住院和专业轮换的需求后整理在一起。同样,临床医生通常会在有限的临床时间与教学,研究或行政职责之间取得平衡。为了寻求改善护理连续性的方法,我们访问了全美23家内科,家庭医学和儿科住院诊所。本文重点介绍了由3家具有高连续性的“亮点”住院医师教学诊所率先提出的优化护理连续性的策略。这些策略包括采用强大的连续性文化和优先安排连续性的患者调度算法,任命团队连续性锚点,和/或重新组织住院医师和教职员工的日程安排,以最大化连续性。我们希望这些观点可以帮助住院医师教学实践,以改善对患者的护理连续性。

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