Medical Home in the Resident Continuity Clinic

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Medical Home in the Resident Continuity Clinic

• Community Pediatrics Training Initiative --Dyson

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• Overview of Medical Home Alan Kohrt, MD
• Understand how Medical Home overlaps with
  residency competencies Beth Rezet, MD
• Be familiar with faculty development and resident
  assessment strategies in Continuity Clinic on the
  Medical Home --Louise Iwaishi, MD
• Learn how to develop and use curricular tools to
  implement Medical Home - Nancy Swigonski, MD
• Understand and integrate family partnerships in
  Continuity Clinics Alan Kohrt, MD

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3 Focus Areas for the Continuity Experience
and the Medical Home

• Teach, model and demonstrate resident competency
  in
• preventive and acute care pediatrics for all
  children, NKD(Y) and CYSHCN
• chronic condition care, including psychosocial
• advocacy at all levels
• quality improvement

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Can we just work harder?

• No
• We have to change the systems
• The Medical Home is a systems change

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The Primary Care Triad
Identification and monitoring (registry)
Care plans and care coordination
CCM office visits
Co-management with specialists
Other (patient education, advocacy, outreach)
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A Continuity Clinic
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25-30 or more of primary care office visits
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• Resident Requirements

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• Obstacles are those frightful things you see when
  you take your mind off your goals
• - unknown

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continuity clinic
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parent partners

• Provide chronic condition management
• Transition CYSHCN into adult care

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Using the Medical Home as a Framework for the
Continuity Clinic Experience

• Preventive Care--Triaging and family focused
  education and care, life-style issues
• Acute Care--Injuries, change in infectious
  disease
• Chronic Care--Model for systems change
• Quality Improvement--Process for change

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MHLC II

• Family Advisors/ Parent Partners
• Alan Kohrt
• Thanks to Jeannie McAllister, Maureen Mitchell

EPIC IC
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Peace of mind and a sense of belonging. That is
what being part of a medical home has done for
me.
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Steps to a Successful Family Advisor (Parent
Partner)

• Picking a family advisor(s)
• Criteria
• Implementing a family advisor(s) system
• Roles, responsibilities
• Setting up meeting times

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Qualities of Effective Family Advisor (PP)
Programs

• More than one parentdifferent ages, needs,
  experience
• Parents
• Ability to relate to others and their experiences
• Currently not in crisis, but has experience with
  care challenges
• Knowledge of HC system, community resources,
  educational, financial, legal
• Team player, assumes responsibility
• Respect practice boundaries

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We must be the change we wish to see in the
world.Gandhi
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Hang ON, Im Changing!!!!
I
i
I
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