Background  There is an unmet need for formal curricula to deliver practice feedback training to residents. Objective  We developed a curriculum to help residents receive and interpret individual practice feedback data and to engage them in quality improvement efforts. Methods  We created a framework based on resident attribution, effective metric selection, faculty coaching, peer and site comparisons, and resident-driven goals. The curriculum used electronic health record–generated resident-level data and disease-specific ambulatory didactics to help motivate quality improvement efforts. It was rolled out to 144 internal medicine residents practicing at 1 of 4 primary care clinic sites from July 2016 to June 2017. Resident attitudes and behaviors were tracked with presurveys and postsurveys, completed by 126 (88%) and 85 (59%) residents, respectively. Data log-ins and completion of educational activities were monitored. Group-level performance data were tracked using run charts. Results  Survey results demonstrated significant improvements on a 5-point Likert scale in residents' self-reported ability to receive (from a mean of 2.0 to 3.3, P < .001) and to interpret and understand (mean of 2.4 to 3.2, P < .001) their practice performance data. There was also an increased likelihood they would report that their practice had seen improvements in patient care (13% versus 35%, P < .001). Run charts demonstrated no change in patient outcome metrics. Conclusions  A learner-centered longitudinal curriculum on ambulatory patient panels can help residents develop competency in receiving, interpreting, and effectively applying individualized practice performance data.

Background: Reinfection and partner transmission are common with Neisseria gonorrhoeae (GC) and Chlamydia trachomatis (CT). We assessed treatment and follow-up laboratory testing for GC and CT and evaluated associations with patient-and system-level factors. Methods:The analysis included positive GC and/or CT nucleic acid amplification test results from patients aged 14 to 24 years at a federally qualified health center system site in Denver, CO, from January 2018 to December 2019. Outcomes assessed include treatment within 14 days, HIV/syphilis testing within 6 months, and repeat GC and CT testing within 2 to 6 months. Bivariate and multivariable regression modeling assessed associated factors.Results: Among 27,168 GC/CT nucleic acid amplification tests performed, 1.8% (484) were positive for GC and 7.8% (2125) were positive for CT. Within the assessed time frames, 87% (2275) of patients were treated, 54.1% (1411) had HIV testing, 50.1% (1306) had syphilis testing, and 39.9% (1040) had GC and CT retesting. Older patients were more likely to receive treatment (adjusted odds ratio 1.13; 95% confidence interval, 1.00-1.27; P = 0.05) than younger patients, whereas males were less likely to receive GC and CT retesting (adjusted odds ratio, 0.19; 95% confidence interval, 0.11-0.33; P < 0.001) than females. Patients treated on the day of testing were less likely to receive follow-up laboratory tests than those treated 2 to 14 days after.Conclusions: Although most patients received antibiotic treatment, only about half received HIV/syphilis testing and less than half received GC and CT retesting. It is critical to find innovative strategies to improve treatment and follow-up management of these infections to decrease complications, reduce transmission, and combat the rising rates of sexually transmitted infections.N eisseria gonorrhoeae (GC) and Chlamydia trachomatis (CT) are the 2 most commonly reported sexually transmitted infections (STIs) in the United States, and the prevalence has increased substantially in the past decade. 1 Adolescents and young adults aged 14 to 24 years make up half of the new STI diagnoses each year despite comprising only one-quarter of the sexually active population. 2 In addition, antibiotic-resistant GC infection is listed on the Centers for Disease Control and Prevention's (CDCs) urgent threat list. 3,4 Untreated infections result in considerable morbidity and may lead to infertility in women. 5,6 Thus, prompt treatment is imperative to prevent complications and to reduce disease transmission. 7,8 Patients with GC and/or CT also have an increased risk of human immunodeficiency virus (HIV) transmission, and they may not use condoms consistently; thus, HIV testing is recommended for individuals who have GC and/or CT infections. 7,8 Given escalating rates of syphilis in Denver, CO, routine syphilis testing after a GC and/or CT infection is recommended based on national guidelines recommending testing for syphilis in highrisk individuals (residence in high-prevalence areas or other risk fact...

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Overall, there are a number of community programs that want to, and can, help veterans with dementia. There are also a number of ways to help veterans with dementia cope with their issues, which include technology and preventative care. Veterans are hindered from receiving help with their dementia concerns due to most veteran's dependence on the Veterans Affairs (VA) for health services, a lack of education about possible treatments and programs, and a lack of services in rural areas. This review will prove useful to providers when evaluating the expansion of VA services and caregiver interventions.