Advancing Primary Care Access: Exploring the Impact of the Virtual Waiting Room on the Quadruple Aim.

Background: Community health centers grapple with high no-show rates, posing challenges to patient access and primary care provider (PCP) utilization.

Aim: To address these challenges, we implemented a virtual waiting room (VWR) program in April 2023 to enhance patient access and boost PCP utilization.

Setting: Academic community health center in a small urban city in Massachusetts.

Patients, Nurses, and Physicians Working Together to Develop a Discharge Entrustable Professional Activity Assessment Tool.

Problem: The Accreditation Council for Graduate Medical Education milestones were written by physicians and thus may not reflect all the behaviors necessary for physicians to optimize their performance as a key member of an interprofessional team.

Approach: From April to May 2013, the authors, Educational Research Outcomes Collaborative leaders, assembled interprofessional team discussion groups, including patients or family members, nurses, physician trainees, physician educators, and other staff (optional), at 11 internal medicine (IM) programs. Led by the site's principal investigator, the groups generated a list of physician behaviors related to the entrustable professional activity (EPA) of a safe and effective discharge of a patient from the hospital, and prioritized those behaviors.

Practice Transformation: Professional Development Is Personal.

Current efforts to achieve practice transformation in our health care delivery system are, for good reason, primarily focused on technical change. Such efforts include meaningful use, population health metrics reporting, and the creation and sustaining of team-based patient-centered medical home delivery sites. If practice transformation is meant to ultimately and fundamentally transform the health care system and its culture to achieve the quadruple aim of better health, better care, affordability, and satisfaction of patients and providers, these technical changes are necessary but not sufficient.

TRACER: an 'eye-opener' to the patient experience across the transition of care in an internal medicine resident program.

Background: A safe patient transition requires a complex set of physician skills within the interprofessional practice.

Objective: To evaluate a rotation which applies self-reflection and workplace learning in a TRAnsition of CarE Rotation (TRACER) for internal medicine (IM) residents. TRACER is a 2-week required IM resident rotation where trainees join a ward team as a quality officer and follow patients into postacute care.

Found in transition: applying milestones to three unique discharge curricula.

Introduction. A safe and effective transition from hospital to post-acute care is a complex and important physician competency. Milestones and Entrustable Professional Activities (EPA) form the new educational rubric in Graduate Medical Education Training.

Nurturing 21st century physician knowledge, skills and attitudes with medical home innovations: the Wright Center for Graduate Medical Education teaching health center curriculum experience.

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.

Playing with curricular milestones in the educational sandbox: Q-sort results from an internal medicine educational collaborative.

Purpose: In competency-based medical education, the focus of assessment is on learner demonstration of predefined outcomes or competencies. One strategy being used in internal medicine (IM) is applying curricular milestones to assessment and reporting milestones to competence determination. The authors report a practical method for identifying sets of curricular milestones for assessment of a landmark, or a point where a resident can be entrusted with increased responsibility.

There is no "i" in teamwork in the patient-centered medical home: defining teamwork competencies for academic practice.

Evidence suggests that teamwork is essential for safe, reliable practice. Creating health care teams able to function effectively in patient-centered medical homes (PCMHs), practices that organize care around the patient and demonstrate achievement of defined quality care standards, remains challenging. Preparing trainees for practice in interprofessional teams is particularly challenging in academic health centers where health professions curricula are largely siloed.

From theory to actual practice: creation and application of milestones in an internal medicine residency program, 2004-2010.

Background: In the USA, the Accreditation Council of Graduate Medical Education, Educational Innovations Project is a partner in reshaping residency training to meet increasingly complex systems of health care delivery.

Aim: We describe the creation and implementation of milestones as a vehicle for translating educational theory into practice in preparing residents to provide safe, autonomous patient care.

Method: Six program faculty leaders, all with advanced medical education training, met in an iterative process of developing, implementing, and modifying milestones until a final set were vetted.

The increased financial burden of further proposed orthopaedic resident work-hour reductions.

Background: Increased funding for graduate medical education was not provided during implementation of the eighty-hour work week. Many teaching hospitals responded to decreased work hours by hiring physician extenders to maintain continuity of care. Recent proposals have included a further decrease in work hours to a total of fifty-six hours.

Early medical and behavioral characteristics of NICU infants later classified with ASD.

Objectives: Recent evidence suggests higher prevalence of autism spectrum disorder (ASD) in NICU graduates. This aim of this study was to identify retrospectively early behaviors found more frequently in NICU infants who went on to develop ASD.

Methods: Twenty-eight NICU graduates who later received a diagnosis of ASD were compared with 2169 other NICU graduates recruited from 1994 to 2005.

Effect of a clinical pharmacist's interventions on duration of antiretroviral-related errors in hospitalized patients.

Purpose: The effect of a clinical pharmacist's interventions on the duration of antiretroviral-related errors in hospitalized patients was studied.

Methods: Between August 4, 2005, and February 4, 2006, all patients at least 18 years of age who were admitted to a 651-bed tertiary care teaching hospital and prescribed highly active antiretroviral therapy (HAART) were identified by one clinical pharmacist. If a HAART error was suspected, the pharmacist intervened with the house staff or outpatient physician to discuss and resolve the problem.