Organized continuity panel reassignment.

BACKGROUND

Structured continuity clinical experience is required in all primary care residency programs. There is a paucity of data on whether continuity patient panels are routinely used, what the ideal panel composition is, how panels are managed within residency programs across the country, and the outcomes related to this training requirement.

METHODS

We designed an organized continuity panel reassignment process with the goal of producing balanced resident panels, that is, panels with similar numbers of patients by race/ethnicity, sex, and age group, as well as comparable numbers of patients with diabetes and those with high health care use. This project focused on postgraduate year-1 (PGY-1) panels to use balanced panels for redesign and focus of their initial training experiences on practice-based learning and patient care continuity.

RESULTS

Findings suggest improved parity in patient care experiences through more evenly distributed panels. Furthermore, the focus on panel review and case management enhanced the curriculum for PGY-1 residents, whose clinical experiences and diabetes clinical quality indicators compared more favorably to residents in earlier classes.

CONCLUSIONS

Balanced continuity panels provide an enhanced substrate for building clinical curricula. Preliminary data suggest that this process helped contribute to improved quality indicators for patients with diabetes.