teaching residents about continuity of care
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Teaching Residents About Continuity of Care. Queen’s University Health Sciences Education Rounds November 15, 2007 Dr. Karen Schultz. Overview. Why teach this? Why change? Process to making changes What we did How we’re going to evaluate it. - PowerPoint PPT PresentationTRANSCRIPT
Teaching Residents About Continuity of Care
Queen’s University Health Sciences Education Rounds
November 15, 2007
Dr. Karen Schultz
Overview
Why teach this? Why change? Process to making changes What we did How we’re going to evaluate it
Why even teach this or What’s so important about continuity of care?
Increased patient satisfaction Improved patient outcomes Increased physician satisfaction
Why Change?
Continuity of care is good=the carrot
Because we were told we had to=the stick!
What we had been doing
4 months in first year 4 months in second year—often 2 x 2
What many other FM programs do ½ day back
Queen’s and the ½ day back
Evidence? Set up of the program
Queen’s Family Medicine Rotation Sites
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
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
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
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”?
RESEARCH!!
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
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
Step 1: What are the components of IP C of C for the HC provider? Qualitative research What do I know of qualitative research?
The steps to step 1
Reading Conferences
– Workshops– Listening to others, looking at posters
Colleagues Networking
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
Step 2: the Survey
Quantitative research What do I know of quantitative research?
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
What I’ve learned so far
Get a stats degree Collaborate
Discussion
Collaborating– Across disciplines
Getting grants in medical education ??