Residency Practice Transformation: Implementation of Team-Based Care in an Academic Continuity Clinic

Area of Science:

• Academic Internal Medicine
• Healthcare Delivery Models
• Team-Based Care

Background:

• Team-based primary care models offer potential for enhanced care delivery.
• Residency scheduling and precepting structures present challenges to establishing effective ambulatory care teams.

Purpose of the Study:

• To describe the implementation and outcomes of a team-based care transformation in an academic internal medicine residency practice.

Main Methods:

• Transitioned to a 6+2 schedule, dividing the clinic into teams with dedicated preceptors, social work, and care coordination.
• Implemented weekly team meetings and pre-clinic huddles for panel management and staff integration.
• Assessed resident, faculty, and staff perceptions via pre- and post-transformation surveys and monitored patient-physician continuity.

Main Results:

• Significant improvements in resident satisfaction (3.05 to 4.07) and perceptions of teamwork (4.14 to 4.61) were observed.
• Patient-primary care physician (PCP) continuity increased substantially from 45% to over 70%.
• Faculty and staff reported domain-specific improvements, but overall perceptions of teamwork did not change significantly.

Conclusions:

• Team-based care implementation successfully enhanced patient continuity and resident satisfaction.
• While residents reported improved teamwork perceptions, the impact on faculty and staff was limited, indicating areas for further optimization.