Effects of a Focused Patient-Centered Care Curriculum on the Experiences of Internal Medicine Residents and their Patients

被引:40
作者
Ratanawongsa, Neda [2 ,3 ]
Federowicz, Molly A. [4 ]
Christmas, Colleen [4 ]
Hanyok, Laura A. [4 ]
Record, Janet D. [4 ]
Hellmann, David B. [4 ]
Ziegelstein, Roy C. [4 ]
Rand, Cynthia S. [1 ,4 ]
机构
[1] JHAC, Dept Med, Baltimore, MD 21224 USA
[2] Univ Calif San Francisco, San Francisco Gen Hosp, UCSF Ctr Vulnerable Populat, San Francisco, CA USA
[3] Univ Calif San Francisco, Ctr Trauma, San Francisco, CA 94143 USA
[4] Johns Hopkins Univ, Sch Med, Johns Hopkins Bayview Med Ctr, Baltimore, MD USA
关键词
residency education; patient-centered care; EDUCATION; SATISFACTION; ASSOCIATION; SERVICE;
D O I
10.1007/s11606-011-1881-8
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Traditional residency training may not promote competencies in patient-centered care. To improve residents' competencies in delivering patient-centered care. Internal medicine residents at a university-based teaching hospital in Baltimore, Maryland. One inpatient team admitted half the usual census and was exposed to a multi-modal patient-centered care curriculum to promote knowledge of patients as individuals, improve patient transitions of care, and reduce barriers to medication adherence. Annual resident surveys (N = 40) revealed that the intervention was judged as professionally valuable (90%) and important to their training (90%) and offered experiences not available during other rotations (88%). Compared to standard inpatient rotation evaluations (n = 163), intervention rotation evaluations (n = 51) showed no differences in ratings for traditional medical learning, but higher ratings for improving how housestaff address patient medication adherence, communicate with patients about post-hospital transition of care, and know their patients as people (all p < 0.01). On post-discharge surveys, patients from the intervention team (N = 177, score 90.4, percentile ranking 97%) reported greater satisfaction with physicians than patients on standard teams (N = 924, score 86.1, percentile ranking 47%) p < 0.01). A patient-centered inpatient curriculum was associated with higher satisfaction ratings in patient-centered domains by internal medicine residents and with higher satisfaction ratings of their physicians by patients. Future research will explore the intervention's impact on clinical outcomes.
引用
收藏
页码:473 / 477
页数:5
相关论文
共 24 条
[11]  
Liu Stanley Shi-Dan, 2010, Ann Intern Med, V153, P614, DOI 10.7326/0003-4819-153-9-201011020-00014
[12]   Patients as partners in radiology education: An innovative approach to teaching and assessing patient-centered communication [J].
Lown, Beth A. ;
Sasson, J. Pierre ;
Hinrichs, Peg .
ACADEMIC RADIOLOGY, 2008, 15 (04) :425-432
[13]   Redesigning Residency Education -- Moving beyond Work Hours. [J].
Ludmerer, Kenneth M. .
NEW ENGLAND JOURNAL OF MEDICINE, 2010, 362 (14) :1337-1338
[14]   Hospital to home: Improving internal medicine residents' understanding of the needs of older persons after a hospital stay [J].
Matter, CA ;
Speice, JA ;
McCann, R ;
Mendelson, DA ;
McCormick, K ;
Friedman, S ;
Medina-Walpole, A ;
Clark, NS .
ACADEMIC MEDICINE, 2003, 78 (08) :793-797
[15]   Evaluation of a Redesign Initiative in an Internal-Medicine Residency. [J].
McMahon, Graham T. ;
Katz, Joel T. ;
Thorndike, Mary E. ;
Levy, Bruce D. ;
Loscalzo, Joseph .
NEW ENGLAND JOURNAL OF MEDICINE, 2010, 362 (14) :1304-1311
[16]   Effects of physician experience on costs and outcomes on an academic general medicine service: Results of a trial of hospitalists [J].
Meltzer, D ;
Manning, WG ;
Morrison, J ;
Shah, MN ;
Jin, L ;
Guth, T ;
Levinson, W .
ANNALS OF INTERNAL MEDICINE, 2002, 137 (11) :866-874
[17]  
Ratanawongsa Neda, 2009, Pharos Alpha Omega Alpha Honor Med Soc, V72, P4
[18]   Reducing Heart Failure Readmissions by Teaching Patient-Centered Care to Internal Medicine Residents [J].
Record, Janet D. ;
Rand, Cynthia ;
Christmas, Colleen ;
Hanyok, Laura ;
Federowicz, Molly ;
Bilderback, Andrew ;
Patel, Amar ;
Khajuria, Suheir ;
Hellmann, David B. ;
Ziegelstein, Roy C. .
ARCHIVES OF INTERNAL MEDICINE, 2011, 171 (09) :858-859
[19]   Systematic Review: Association of Shift Length, Protected Sleep Time, and Night Float With Patient Care, Residents' Health, and Education [J].
Reed, Darcy A. ;
Fletcher, Kathlyn E. ;
Arora, Vineet M. .
ANNALS OF INTERNAL MEDICINE, 2010, 153 (12) :829-+
[20]   Implementation of a Physician Assistant/Hospitalist Service in an Academic Medical Center: Impact on Efficiency and Patient Outcomes [J].
Roy, Christopher L. ;
Liang, Catherine L. ;
Lund, Maha ;
Boyd, Catherine ;
Katz, Joel T. ;
McKean, Sylvia ;
Schnipper, Jeffrey L. .
JOURNAL OF HOSPITAL MEDICINE, 2008, 3 (05) :361-368