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 Gre

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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
Educational Innovations ProjectUniversity of
Cincinnati
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• Focus during practice portion of the long block
  will be building skills in ambulatory care and
  practice management

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• 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

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• Elective the balance of the time will be spent
  on self-selected specialty elective rotations
• Residents will set own call and vacation
  schedules

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• 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 residents sense of control over
  scheduling

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• Patient Care these innovations will
• Improve quality of care
• Improve continuity of care
• Improve access to care

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• 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
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• 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

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• Resident Learning these innovations will
• Decompress post call days
• Decrease resident fatigue
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• Patient Care these innovations will
• Improve continuity across transitions of care
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• Methods
• Create ambulatory and inpatient
  interprofessional teams
• Provide teams with real-time quality markers of
  care

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• 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
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• Methods
• Residents will create and refine decision
  support tools for the EMR using evidence based
  guidelines
• Manage chronic conditions with computerized
  disease registries
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• Resident Learning these innovations will
• Teach residents to create/refine support tools
  within an EMR
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• Patient Care these innovations will
• Track quality on individual and population
  levels
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• Methods
• Ambulatory
• One half day will be devoted to education
• Minimize passive learning techniques
• Initial core curriculum, then resident determined

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• 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

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• Resident Learning these innovations will
• Be learner-centered
• Patient Care these innovations will
• Enrich resident physicians with practical skills
  that directly affect
• patient care
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• 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 residents self rating
  and other
• evaluations
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• 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
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• 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
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• Resident Learning these innovations will
• Enable residents to concentrate or broaden
  elective
• experiences depending on ultimate career
  choice
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• Patient Care these innovations will
• Improve resident motivation across clinical
  settings
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