Related Experiment Videos
Separating Residents' Inpatient and Outpatient Responsibilities: Improving Patient Safety, Learning Environments, and
Carol K Bates1, Julius Yang, Grace Huang
1C.K. Bates is associate professor of medicine, Harvard Medical School, Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, and associate dean for faculty affairs, Harvard Medical School, Boston, Massachusetts. J. Yang is assistant professor of medicine, Harvard Medical School, Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, director of inpatient quality, Department of Health Care Quality, and associate director of the internal medicine residency program, Beth Israel Deaconess Medical Center, Boston, Massachusetts. G. Huang is associate professor of medicine, Harvard Medical School, Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Boston, Massachusetts. A.V. Tess is associate professor of medicine, Harvard Medical School, Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, and associate director of the internal medicine residency program, Beth Israel Deaconess Medical Center, Boston, Massachusetts. E. Reynolds is associate professor of medicine, Harvard Medical School, Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, and vice chair for education, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts. A. Vanka is instructor in medicine, Harvard Medical School, Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, and associate director of the internal medicine residency program, Beth Israel Deaconess Medical Center, Boston, Massachusetts. L. Caines is assistant clinical professor and codirector of the medical school course on Introduction to Clinical Medicine, University of Connecticut School of Medicine, Farmington, Connecticut. C.C. Smith is associate professor of medicine, Harvard Medical School, Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, and director of the internal medicine residency progra
The Alternating Call and Elective Scheduling (ACES) model significantly improved internal medicine resident schedules, enhancing patient safety and resident-physician relationships. This innovative scheduling model led to higher resident satisfaction and increased patient visit continuity.
Area of Science:
- Medical Education
- Healthcare Management
- Patient Safety
Background:
- Current internal medicine residency regulations mandate schedules that minimize conflicts between inpatient and outpatient duties.
- The Alternating Call and Elective Scheduling (ACES) model was implemented to address these regulatory requirements and improve resident training.
Purpose of the Study:
- To evaluate the impact of the ACES model on internal medicine resident schedules.
- To assess improvements in patient safety, the learning environment, and resident-patient relationships.
Main Methods:
- The ACES model was implemented for 95 postgraduate year 2 and 3 residents.
- Data collected included pre- and post-implementation surveys on program evaluation and safety culture.
- Resident schedule data and patient visit statistics were analyzed.
Main Results:
- Resident agreement that schedules minimized inpatient/outpatient conflict rose from 16% to 98%.
- Perceptions of inpatient safety improved from 28% to 99%, and outpatient safety from 34% to 87%.
- Resident-patient relationship quality improved (54% to 80%), with a 14% increase in continuity visits.
Conclusions:
- Separating inpatient and outpatient responsibilities enhances patient safety, the learning environment, and resident-patient continuity.
- Further innovations should focus on outpatient patient safety and reducing resident stress.
Related Concept Videos
01:31Discharge Summary Forms
Here's a detailed look at the key components and guidelines for preparing a discharge summary:
01:13Patient-centered Care
01:29Documentation in Long-Term and Home Healthcare Setting
Long-Term Care Facilities
00:59Hospitals-II
Nurses that work in...
01:21Planning Nursing Care I
01:19Restorative Care