Purpose. The effect of patient centered medical home (PCMH) curriculum interventions on residents’ self-reported and demonstrated knowledge, skills and attitudes in PCMH competency arenas (KSA) is lacking in the literature. This study aimed to assess the impact of PCMH curricular innovations on the KSA of Internal Medicine residents.Methods. Twenty four (24) Internal Medicine residents—12 Traditional (TR) track residents and 12 Teaching Health Center (THC) track residents—began training in Academic Year (AY) 2011 at the Wright Center for Graduate Medical Education (WCGME). They were followed through AY2013, covering three years of training. PCMH curricular innovations were focally applied July 2011 until May 2012 to THC residents. These curricular innovations were spread program-wide in May 2012. Semi-annual, validated PCMH Clinician Assessments assessing KSA were started in AY2011 and were completed by all residents.Results. Mean KSA scores of TR residents were similar to those of THC residents at baseline for all PCMH competencies. In May 2012, mean scores of THC residents were significantly higher than TR residents for most KSA. After program-wide implementation of PCMH innovations, mean scores of TR residents for all KSA improved and most became equalized to those of THC residents. Globally improved KSA scores of THC and TR residents were maintained through May 2014, with the majority of improvements above baseline and reaching statistical significance.Conclusions. PCMH curricular innovations inspired by Health Resources and Services Administration (HRSA’s) Teaching Health Center funded residency program expansion quickly and consistently improved the KSA of Internal Medicine residents.
More than 105 million referrals of Medicare beneficiaries to specialists occur annually. Different settings and electronic health records have made care coordination complex. PCPI (formerly American Medical Association-convened Physicians Consortium for Performance Improvement) and The Wright Center for Graduate Medical Education sponsored the Closing the Referral Loop pilot project. Twelve dyads of primary care and specialist physicians sought to improve ambulatory referrals by mapping the referral process, and using care compacts, metrics, and electronic health records. Referrals closed on time increased from 40% to 70%. Clinical questions answered increased from 50% to 75%. Adoption of the change package and lessons from this project may significantly improve ambulatory referral management.
ObjectivesIn this study, we have developed an electrocardiogram-based scoring system to predict secondary pulmonary hypertension.DesignA cross-sectional study.SettingSingle tertiary-care hospital in Scranton, Pennsylvania, USA.ParticipantsFive hundred and fifty-two consecutive patients undergoing right heart catheterization between 2006 and 2009.Main outcome measuresSurface electrocardiogram was assessed for R-wave in lead V1 ≥ 6mm, R-wave in V6 ≤ 3mm, S-wave in V6 ≥ 3mm, right atrial enlargement, right axis deviation and left atrial enlargement. Pulmonary hypertension was defined as mean pulmonary artery pressure ≥25 mmHg, determined by right heart catheterization.ResultsA total of 297 (54%) patients in the study cohort had pulmonary hypertension. In total, 332 patients from the study cohort formed the development cohort and the remaining 220 patients formed the validation cohort. In the development cohort, based on log odds ratios of association, RAE, LAE, RAD, R-wave in V1 ≥ 6 mm were assigned scores of 5, 2, 2 and 1, respectively, to form a 10-point scoring system “Scranton PHT (SP) score”. SP scores of 5 points and 7 points in DC showed C-statistic of 0.83 and 0.89, respectively, for discriminating pulmonary hypertension. C-statistic for RAE alone was significantly lower compared to an SP score of 7 (0.83 vs. 0.89, P = 0.021). The reliability of SP score in the validation cohort was acceptable.ConclusionSP score provides a good point-of-care tool to predict pulmonary hypertension in patients with clinical suspicion of it.
Purpose: Effect of patient centered medical home (PCMH) curriculum interventions on residents’ self-reported and demonstrated knowledge, skills and attitudes (KSA) in PCMH competency arenas is lacking in the literature. This study aimed to assess impact of PCMH curricular innovations on Internal Medicine residents’ self-reported KSA. Method: Twenty four (24) Internal Medicine residents - 12 Traditional (TR) track and 12 Teaching Health Center (THC) track - began training in academic year (AY) 2011 at the Wright Center for Graduate Medical Education (WCGME). They were followed through AY2013 covering three years of training. PCMH curricular innovations were applied beginning July 2011 until May 2012 focally to THC residents. These curricular innovations were spread program wide in May 2012. Semi-annual validated PCMH Clinician Assessments assessing PCMH competencies based on self-reported KSA were started in AY2011 and completed by all residents. Results: Mean self-reported KSA scores of TR residents were similar to THC residents at baseline for all PCMH competencies. In May 2012, mean scores of THC residents were significantly higher than 2011 and graduating 2009 TR residents for most PCMH competencies. After program wide implementation of PCMH innovations, mean scores of 2011 and 2010 TR residents for all PCMH competencies improved and most equalized to those of 2011 THC residents. Globally improved PCMH competency scores of 2011 THC and TR residents were maintained through May 2014, with majority of improvements above baseline reaching statistical significance. Conclusions: PCMH curricular innovations inspired by HRSA’s Teaching Health Center funded residency program expansion quickly and consistently improved Internal Medicine residents’ self-reported KSA of PCMH competencies and improvements were sustained.
Purpose: Effect of patient centered medical home (PCMH) curriculum interventions on residents’ self-reported and demonstrated knowledge, skills and attitudes (KSA) in PCMH competency arenas is lacking in the literature. This study aimed to assess impact of PCMH curricular innovations on Internal Medicine residents’ self-reported KSA. Method: Twenty four (24) Internal Medicine residents - 12 Traditional (TR) track and 12 Teaching Health Center (THC) track - began training in academic year (AY) 2011 at the Wright Center for Graduate Medical Education (WCGME). They were followed through AY2013 covering three years of training. PCMH curricular innovations were applied beginning July 2011 until May 2012 focally to THC residents. These curricular innovations were spread program wide in May 2012. Semi-annual validated PCMH Clinician Assessments assessing PCMH competencies based on self-reported KSA were started in AY2011 and completed by all residents. Results: Mean self-reported KSA scores of TR residents were similar to THC residents at baseline for all PCMH competencies. In May 2012, mean scores of THC residents were significantly higher than 2011 and graduating 2009 TR residents for most PCMH competencies. After program wide implementation of PCMH innovations, mean scores of 2011 and 2010 TR residents for all PCMH competencies improved and most equalized to those of 2011 THC residents. Globally improved PCMH competency scores of 2011 THC and TR residents were maintained through May 2014, with majority of improvements above baseline reaching statistical significance. Conclusions: PCMH curricular innovations inspired by HRSA’s Teaching Health Center funded residency program expansion quickly and consistently improved Internal Medicine residents’ self-reported KSA of PCMH competencies and improvements were sustained.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.