Resident Continuity Practice provides the opportunity for residents to assume the role of the primary care provider for a panel of patients, many of whom the residents meet when they are hospitalized for an acute illness and are identified as someone who needs a “family doctor”.

During 2007-2008 we began one of the more exciting aspects of OSU’s Educational Innovations Project. Instead of attending a half-day weekly clinic throughout their years of training, residents have Continuity Practice Blocks (CPB) every third month, during which they see patients 3-4 half days/week. They share the care of their patients with members of their 3 resident Practice Group (comprised from all three years of training), rotating monthly. Patients still have one resident they consider their primary physician, despite the team design.

CPB allows trainees to immerse themselves in the ambulatory practice setting with a more real-world primary care schedule during that month. They do not have inpatient responsibilities beckoning them from the clinic. Likewise, when they are on an inpatient ward or non-CPB elective assignment, their responsibilities are not be interrupted by a weekly clinic. Educational conferences also target the setting where the learner is working—an ambulatory conference series is distinct from "morning" report for those in the hospital.

A full array of inpatient and outpatient consult services are available by referral. Ancillary support in the clinic includes a dedicated triage nurse who handles calls for prescription refills when residents are not in clinic.

Ambulatory Education:

All residents participate in the Johns Hopkins Ambulatory Modules. These modules are assigned to be completed on a quarterly basis and are discussed by faculty during clinic time. Our senior residents have found that they are an excellent board review tool. Each year, residents vie for monetary awards that recognize the resident who completes the most modules as well as those who score the highest on the end of year assessment.

The OSUMC internal medicine residency was one of a pilot group of residency programs to use the ABIM Performance Improvement Module (PIM) as part of residency education.  The ABIM PIM on Preventive Cardiology was carried out by the resident firms, teaching them about effective measurement of care processes and outcomes; quality improvement strategies and patient satisfaction.  As part of the educational innovations project, a new PIM will be chosen by the residents to measure and improve care each year.  In addition to the satisfaction that comes with knowing you have improved your patient care, residents completing our program will be totally comfortable with this essential component of maintenance of certification that will be required post residency to maintain their ABIM certification. 

There have been three exciting changes in the continuity practice experience:

1. In October of 2007, the resident clinic practice moved to the newly renovated Martha Morehouse Plaza. This site, 2 minutes from the main campus, has beautiful exam and conference rooms which will enhance the educational experience for the residents.
2. At the same time, the resident and faculty practice were merged into one practice. This allowed residents to practice side by side with the faculty and benefit from all of the support infrastructure that is found in typical faculty practices.  During their continuity practice, residents have a dedicated preceptor who is not seeing patients but is there to supervise their outpatient experience. We find this keeps the wait time to staff patients to a minimum.
3. In June of 2008, we launched a new and comprehensive outpatient electronic health record (EHR). This new record allows for easy note writing, using templates and pull down menus; a wonderful reminder system that helps physicians remember to order appropriate screening tests, check ordered labs and followup on consults.  This EHR is currently being implemented in all consultant clinics within the OSU Health System so following up on consultant recommendations will be easy.

The Educational Innovations Project

The Ambulatory Care arm of the educational innovations project began in July 2006 with continued use of the ABIM PIMS. Ambulatory Working Groups helped implement the Hypertension PIM and were involved in data interpretation and targeting outcomes for intervention for the 2007-2008 year. After post-intervention data is being collected.  We began a PIM focused on diabetes management in 2008-2009 in which data collection is ongoing.