Educational Innovations Project University of Cincinnati

1. Educational Innovations ProjectUniversity of Cincinnati Eric J. Warm M.D., F.A.C.P Tiffiny Diers M.D. Bradley R. Mathis M.D. LeAnn Coberly M.D., F.A.C.P Gregory W. Rouan M.D., F.A.C.P

3. M T W TH F

4. M T W TH F • Focus during “practice” portion of the long block will be building skills in ambulatory care and practice management

5. M T W TH F • One half day a week will be reserved for interprofessional practice team meetings, quality assessment/improvement and resident education • A comprehensive quality and ambulatory skills curriculum is under development

6. M T W TH F • Elective: the balance of the time will be spent on self-selected specialty elective rotations • Residents will set own call and vacation schedules

7. Resident Learning – these innovations will: • Close the training-practice gap • Minimize concurrent inpatient and ambulatory care demands • Provide quality assessment and improvement instruction • Create protected time for skills building and learning • Improve resident’s sense of control over scheduling

8. Patient Care – these innovations will: • Improve quality of care • Improve continuity of care • Improve access to care

9. Methods • Eliminate 24-hour shifts via an expanded night-float • system • Focus on the transitions of care in and out of the • hospital by creation of the Transition of Care Manager

10. Duties of the Transition of Care Manager • Identify and call every Primary Care Physician (PCP) at the • time of admission • At discharge,contact the PCP and forward appropriate • records pro-actively • Serve as a consistent resource for follow-up phone calls

11. Resident Learning – these innovations will: • Decompress post call days • Decrease resident fatigue Patient Care – these innovations will: • Improve continuity across transitions of care

12. Methods • Create ambulatory and inpatient interprofessional teams • Provide teams with real-time quality markers of care

13. Resident Learning – these innovations will: • Train residents to be systems team leaders • Provide personal feedback on performance Patient Care – these innovations will: • Improve integration of care services

14. Methods • Residents will create and refine decision support tools for the EMR using evidence based guidelines • Manage chronic conditions with computerized disease registries

15. Resident Learning – these innovations will: • Teach residents to create/refine support tools within an EMR Patient Care – these innovations will: • Track quality on individual and population levels

16. Methods • Ambulatory • One half day will be devoted to education • Minimize passive learning techniques • Initial core curriculum, then resident determined

17. Methods • Inpatient • The curriculum for all inpatient rotations will include an • achievable (but not encyclopedic) set of goals and objectives • Curriculum-based exams will be taken at the midpoint of each • rotation • Results can serve as a focus for learning for the rest of the • rotation

18. Resident Learning – these innovations will: • Be learner-centered Patient Care – these innovations will: • Enrich resident physicians with practical skills that directly affect • patient care

19. Methods • Residents will rate their own confidence level at performing the • objectives/skills listed in learning portfolios • Trained mentors will assist residents in improving skills and • confidence in weakly rated areas, or calibrate if there is a • discrepancy between the resident’s self rating and other • evaluations

20. Resident Learning – these innovations will: • Assist residents to self-assess and address weak areas in • performance Patient Care – these innovations will: • Provide more consistent resident performance across the • residency

21. Methods • More elective time in the first year than in the present system • Extensive elective time during the ambulatory block will • enable residents to focus on a specialty of choice

23. Resident Learning – these innovations will: • Enable residents to concentrate or broaden elective • experiences depending on ultimate career choice Patient Care – these innovations will: • Improve resident motivation across clinical settings