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The Continuum of a Primary Care Service Infrastructure and the Development of a Community Pediatrics Program Matilde Irigoyen, Dodi Meyer, and Mary McCord Columbia University, NY Columbia University Department of Pediatrics Tertiary care center Generalist faculty: 25 FTE 60 residents:

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The Continuum of a Primary Care Service Infrastructure and the Development of a Community Pediatrics Program

Matilde Irigoyen, Dodi Meyer, and Mary McCord

Columbia University, NY

columbia university department of pediatrics
Columbia University Department of Pediatrics
  • Tertiary care center
  • Generalist faculty: 25 FTE
  • 60 residents:
    • more than half enter specialties
the community
The Community
  • Demographics: Latino and African American
  • Assets: vibrant Community-Based Organizations
  • Needs: High levels of poverty, poor schools, injuries, and domestic violence
community based primary care service infrastructure
Community-based Primary Care: Service Infrastructure
  • Model: the General Pediatrics Group Practice
  • Decentralized primary care
  • Integrated resident – faculty practices
general pediatric group practice service
General Pediatric Group Practice: Service
  • 16,000 children/year
  • 60,000 visits, scheduled and walk-ins
  • Special health care needs children
  • 24 hour coverage – 7 days/week
  • Inpatient coverage
general pediatric group practice education
General Pediatric Group Practice: Education
  • Leadership roles
  • Main preceptors for residents and medical students in:
    • Continuity clinic
    • Ambulatory block
    • Inpatient wards
community pediatrics beyond hospital walls
Community Pediatrics:Beyond Hospital Walls
  • Reverses community-hospital relationship
  • Moves away from hospital’s institutional culture
  • Promotes knowledge of community resources
  • Facilitates collaboration with community
community based education service learning
Community-based Education: Service Learning
  • Structured educational methodology
  • Combines community service with specific goals and objectives
  • Integrates community members as active partners in program design, implementation and evaluation
community based education for residents examples
Community-based Education for Residents: Examples
  • School health clinic
  • Newborn home visitation program
decentralized primary care pros
Decentralized Primary Care:Pros
  • Fosters mentoring of residents
  • Allows independence and creativity of faculty and sites
  • Closeness to community and Community-Based Organizations
decentralized primary care challenges
Decentralized Primary Care: Challenges
  • Maintaining standards and a unified vision
  • Decentralized faculty and residents: logistical difficulties