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在家庭医学住院医师培训实践中实现国家质量保证委员会(NCQA)以患者为中心的医疗之家(PCMH)认证的协作方法。

A collaborative approach to achieving NCQA PCMH recognition within family medicine residency practices.

作者信息

Brown Carina M, Cronholm Peter F, Wright Jessica, Warning William J, Radosh Lee, Gabbay Robert

机构信息

Penn State College of Medicine.

出版信息

Fam Med. 2014 Jan;46(1):19-27.

Abstract

BACKGROUND AND OBJECTIVES

The Pennsylvania Academy of Family Physicians (PAFP) developed a statewide Residency Program Collaborative (RPC) to facilitate family medicine residency practices in Pennsylvania becoming recognized patient-centered medical homes (PCMHs). This report outlines the methods and a brief evaluation of the RPC, which included 20 residency practices. Participants attended tri-annual learning sessions and monthly conference calls, received physician faculty mentorship, and reported clinical quality data monthly on diabetes and ischemic vascular disease.

METHODS

Two years after the start of the RPC, surveys were sent to residents, staff, providers, and administrators at participating practices to measure attendance and usefulness of collaborative sessions, mentors, and monthly reports. Evaluators also mapped the RPC curriculum to the Accreditation Council of Graduate Medical Education (ACGME) Core Competencies.

RESULTS

All 20 participating practices achieved National Committee for Quality Assurance (NCQA) PCMH recognition, with 17 attaining Level 3 recognition. A total of 295 surveys were collected (92 residents, 71 faculty, and 132 office staff/administrators). Survey data showed higher collaborative attendance for residents and faculty compared to office staff/administrators (~84% versus 45%). No differences were noted between resident and faculty respondents regarding perceived helpfulness of collaborative sessions (6.3 and 6.5, respectively), mentors (6.6 and 6.2) and monthly reports (6.4 and 6.5), with both groups rating these components more highly than staff/administrators (5.3, 5.3, and 5.4 for each category).

CONCLUSIONS

Learning collaboratives can assist residency practices in achieving PCMH recognition while concurrently providing an educational framework aligned with residency program Core Competencies. The RPC intervention, including learning sessions, monthly conference calls, data reporting, and faculty mentors, also can effectively guide residency practices in the PCMH transformation process and can serve as a means to experientially imbue future family physicians with the attitudes and skills to create and effectively operate their practices under PCMH principles.

摘要

背景与目标

宾夕法尼亚家庭医师学会(PAFP)制定了一项全州范围的住院医师培训项目协作计划(RPC),以促进宾夕法尼亚州的家庭医学住院医师培训实践成为公认的以患者为中心的医疗之家(PCMH)。本报告概述了RPC的方法及简要评估,该计划包括20个住院医师培训实践机构。参与者参加每三年一次的学习会议和每月的电话会议,接受医师教员指导,并每月报告糖尿病和缺血性血管疾病的临床质量数据。

方法

RPC启动两年后,向参与实践机构的住院医师、工作人员、提供者和管理人员发送调查问卷,以衡量协作会议、导师和月度报告的参与度和实用性。评估人员还将RPC课程与研究生医学教育认证委员会(ACGME)的核心能力进行了映射。

结果

所有20个参与实践机构均获得了国家质量保证委员会(NCQA)的PCMH认可,其中17个达到了3级认可。共收集了295份调查问卷(92名住院医师、71名教员和132名办公室工作人员/管理人员)。调查数据显示,与办公室工作人员/管理人员相比,住院医师和教员的协作参与度更高(分别约为84%和45%)。住院医师和教员受访者在协作会议(分别为6.3和6.5)、导师(6.6和6.2)和月度报告(6.4和6.5)的感知帮助方面没有差异,两组对这些组成部分的评分均高于工作人员/管理人员(每个类别分别为5.3、5.3和5.4)。

结论

学习协作可以帮助住院医师培训实践获得PCMH认可,同时提供一个与住院医师培训项目核心能力相一致的教育框架。RPC干预措施,包括学习会议、每月电话会议、数据报告和教员导师,还可以有效地指导住院医师培训实践机构进行PCMH转型过程,并可以作为一种手段,让未来的家庭医生在PCMH原则下体验式地灌输创建和有效运营其诊所的态度和技能。

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