Intern Transitions of Care Curriculum Through Posthospital Home and Skilled Nursing Facility Visits

Miller, Rachel; Keddem, Shimrit; Katz, S R; Smith, Zachary; Whitehouse, Christina R.; Goldstein, Kenneth M.; Hirschman, Karen B.; Johnson, Jerry

doi:10.4300/jgme-17-00499.1

Cited by 8 publications

(15 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A limited number of groups have studied how TOC curricula impact resident perceptions of patient care around hospital discharge [ 7 , 8 , 17 ]. One intervention integrated didactics with post-discharge follow up at skilled nursing facilities, nursing homes, and home health nursing visits [ 7 ]. In another study, chart reviews of previously hospitalized patients were used as a way for residents to reflect on their practice and understanding of their patients’ needs [ 8 ].…”

Section: Discussionmentioning

confidence: 99%

“…A third study involved experiential learning, self-learning by reading an article on TOC [ 2 ], facilitated small-group discussions, and writing a self-reflective essay [ 17 ]. Several themes consistently emerged in this prior research: the importance of improved TOC planning [ 7 , 8 , 17 ], the importance of effective communication with receiving providers [ 7 , 8 , 17 ], with patients and families [ 8 , 17 ], and appreciation of social factors that impact safe discharge planning [ 18 ]. These themes correlate with those that were evoked by TEAM calls.…”

Section: Discussionmentioning

confidence: 99%

“…Prior transitions of care curricula have been studied for their effect on clinical and patient-centered outcomes, but few studies have sought to better understand resident perceptions of these programs [ 7 , 8 ]. In 2018, we implemented and adapted the ECHO-CT model to include weekly virtual interdisciplinary conference calls, referred to hereafter as Transitions Expectation and Management (TEAM) calls, between interprofessional providers on the geriatric inpatient unit of the University of Colorado Hospital and the Seniors Clinic (See Fig.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Resident perspectives on the value of interdisciplinary conference calls for geriatric patients

et al. 2021

View full text Add to dashboard Cite

Background There are limited competency-based educational curricula for transitions of care education (TOC) for internal medicine (IM) residency programs. The University of Colorado implemented a virtual interdisciplinary conference call, TEAM (Transitions Expectation and Management), between providers on the inpatient Acute Care of the Elder (ACE) unit and the outpatient Seniors Clinic at the University of Colorado Hospital. Residents rotating on the ACE unit participated in weekly conferences discussing Seniors Clinic patients recently discharged, or currently hospitalized, to address clinical concerns pertaining to TOC. Our goals were to understand resident perceptions of the educational value of these conferences, and to determine if these experiences changed attitudes or practice related to care transitions. Methods We performed an Institutional Review Board-approved qualitative study of IM housestaff who rotated on the ACE unit during 2018–2019. Semi-structured interviews were conducted to understand perceptions of the value of TEAM calls for residents’ own practice and the impact on patient care. Data was analyzed inductively, guided by thematic analysis. Results Of the 32 IM residents and interns who rotated on ACE and were invited to participate, 11 agreed to an interview. Three key themes emerged from interviews that highlighted residents’ experiences identifying and navigating some of their educational ‘blind spots:’ 1) Awareness of patient social complexities, 2) Bridging gaps in communication across healthcare settings, 3) Recognizing the value of other disciplines during transitions. Conclusions This study highlights learner perspectives of the benefit of interdisciplinary conference calls between inpatient and outpatient providers to enhance transitions of care, which provide meaningful feedback and serve as a vehicle for residents to recognize the impact of their care decisions in the broader spectrum of patients’ experience during hospital discharge. Educators can maximize the value of these experiences by promoting reflective debriefs with residents and bringing to light previously unrecognized knowledge gaps around hospital discharge.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Resident perspectives on the value of interdisciplinary conference calls for geriatric patients

et al. 2021

View full text Add to dashboard Cite

show abstract

“…Miller et al 17 describe a curriculum for first-year IM residents that included 1-hour didactic sessions on Transitions of Care followed by post-hospital visit for 1 cohort of residents and SNF visit focusing on important aspects of care transitions. Both cohorts were prompted to reflect on their experiences.…”

Section: Introductionmentioning

confidence: 99%

“…Outcomes included improved awareness of care transitions among learners. 17 Building on these works, we report on our learners' experiences with a "Transitions of Care Curriculum" (TOCC) which was a 2-week long immersive curriculum for first year IM residents and included: Transition of Care Teaching modules, Transition Audit, Transitional Care Site Visits, and Transition of Care Conference. At the end of the rotation, the residents were given a prompt for a Reflective Essay to describe the impact of the care transition on the patient and their doctorpatient relationship, the impact of the experience on their future practice of medicine and to identify barriers that would limit this change.…”

Section: Introductionmentioning

confidence: 99%

Internal Medicine Residents’ Views About Care Transitions: Results of an Educational Intervention

Sheikh

Gathecha

Arbaje

et al. 2021

Journal of Medical Education and Curricular Development

View full text Add to dashboard Cite

Problem: Suboptimal care transitions can lead to re-hospitalizations. Intervention: We developed a 2-week “Transitions of Care Curriculum” to train first-year internal medicine residents to improve their knowledge and skills to deliver optimal transitional care. Our objective was to use reflective writing essays to evaluate the impact of the curriculum on the residents. Methods: The rotation included: Transition of Care Teaching modules, Transition Audit, Transitional Care Site Visits, and Transition of Care Conference. Residents performed the above elements of care transitions during the curriculum and wrote reflective essays about their experiences. These essays were analyzed to assess for the overall impact of the curriculum on the residents. Qualitative analysis of reflective essays was used to evaluate the impact of the curriculum. Of the 20 residents who completed the rotation, 18 reflective essays were available for qualitative analysis. Results: Five major themes identified in the reflective essays for improvement were: discharge planning, patient-centered care, continuity of care, goals of care discussions, and patient safety. The most discussed theme was continuity of care, with following subthemes: fragmentation of the healthcare system, disjointed care to the patients, patient specific factors contributing to lack of continuity of care, lack of primary care provider role as a coordinator of care, and challenges during discharge process. Residents also identified system-based gaps and suggested solutions to overcome these gaps. Conclusions: This experiential learning and use of reflective writing enhanced the residents’ self-identified awareness of gaps in care transitions and prompted them to generate ideas for systems improvement and personal actions to improve their practice during care transitions.

show abstract

Medical Training in Home Care Medicine: The Time is Now

2022

Self Cite

View full text Add to dashboard Cite

Intern Transitions of Care Curriculum Through Posthospital Home and Skilled Nursing Facility Visits

Abstract: An experiential transitions of care curriculum is feasible and acceptable. Residents reported using the curriculum 18 to 20 months after exposure.

Cited by 8 publications

References 22 publications

Resident perspectives on the value of interdisciplinary conference calls for geriatric patients

Resident perspectives on the value of interdisciplinary conference calls for geriatric patients

Internal Medicine Residents’ Views About Care Transitions: Results of an Educational Intervention

Medical Training in Home Care Medicine: The Time is Now

Contact Info

Product

Resources

About