In Search Of Continuity For Resident Continuity Practice

Continuity: Those involved in resident continuity practice will want to make note of this article that describes factors associated with continuity at 4 ambulatory residency training programs (internal medicine, pediatrics, family medicine, and med-peds), all at Level 3 PCMH (Patient-Centered Medical Home) designated practices in Upstate New York. Visit data (provider and patient characteristics) from these sites were compared to those from 30 affiliated non-teaching primary care practices in the community. Of almost 400,000 visits analyzed, continuity was higher in non-teaching community practices (87.3%) compared to resident practices (56%) or faculty practices (62%, p <.001). Factors associated with continuity included consistent use of scheduling protocols, absence of advanced practitioners, higher clinical faculty time, policies for handoffs from graduating seniors to interns, and dismissal policies for excessive missed appointments. While this study confirms what is already known about lack of continuity in resident practices, it also adds useful insight into how we might improve continuity, especially as many of the factors identified should be modifiable and likely not cost-prohibitive.  — Sarang Kim, MD

Fortuna et al, Factors Associated With Resident Continuity In Ambulatory Training Practices. Journal of Graduate Medical Education October 2016

Link To Article

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