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A collaborative model for inpatient training in a small pediatric residency program
Insights
A collaborative pediatric training model between a community hospital and children's hospital successfully maintained a residency program. This innovative approach enhanced patient volume, resident training, and program accreditation.
Area of Science:
- Pediatric Residency Training
- Medical Education Models
- Healthcare Collaboration
Background:
- Declining pediatric admissions threaten community hospital residency programs.
- Limited data exists on how small pediatric programs adapt to these challenges.
- Sustainability of pediatric inpatient training is a growing concern.
Purpose of the Study:
- To design and evaluate a collaborative pediatric inpatient training model.
- To assess the impact of a partnership between a community medical center and a children's hospital.
- To address the challenge of declining patient volumes in pediatric residency programs.
Main Methods:
- Described operational, academic, and financial aspects of the collaborative model.
- Collected outcome data on patient volume, subspecialty mix, and resident/faculty perceptions.
- Included Accreditation Council for Graduate Medical Education (ACGME) Residency Review Committee (RRC) review outcomes.
Main Results:
- Patient volume and subspecialty mix more than tripled after model implementation.
- Residents and faculty reported strengths in responsibility, complex care, teaching, teamwork, and academic participation.
- The collaborating children's hospital experienced increased volume without program disruption.
- The program achieved successful reaccreditation by the RRC.
Conclusions:
- A collaborative inpatient training model effectively sustained a community hospital-based pediatric residency program.
- The model yielded positive outcomes for the residency program, community hospital, and children's hospital.
- This partnership demonstrates a viable solution for maintaining pediatric graduate medical education.
Background:
The nationwide decline in pediatric admissions to community hospitals threatens the sustainability of small pediatric residency programs. Little is known about the response of small programs to this challenge.
Objectives:
We report on the design and evaluation of an innovative, collaborative model for pediatric inpatient training between an academic community medical center and a children's hospital.
Methods:
We describe the operational, academic, and financial features of the model. Outcome measures include patient volume and subspecialty mix, resident and faculty perceptions as reported in an anonymous survey, and Accreditation Council for Graduate Medical Education Residency Review Committee (RRC) review.
Results:
In 2003, Albert Einstein Medical Center (Einstein) closed its pediatric inpatient unit and established an independent teaching service at St Christopher's Hospital for Children (St Christopher's) in Philadelphia, Pennsylvania. Under the new model, patient volume and subspecialty mix more than tripled. Einstein residents and faculty identified 5 major strengths: level of responsibility and decision making, caring for medically complex children, quality of teaching, teamwork, and opportunity to participate in academic activities at a children's hospital. St Christopher's leadership reported increased volume, no disruption of their residency program, and no dilution of clinical teaching material. The Einstein program was reaccredited by the RRC in 2006 for 2 years and in 2009 for 4 years.
Conclusion:
A collaborative model for inpatient training was successful in maintaining a community hospital-based pediatric residency program. Positive outcomes were documented for the residency program, the parent community hospital, and the collaborating children's hospital.
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