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AFMRD - Clinic First Collaborative
The way to a high-performing residency practice environment.
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What is the AFMRD - Clinic First Collaborative?
The AFMRD and the UCSF Center for Excellence in Primary Care (CEPC) are sponsoring a collaborative for family medicine residency programs interested in moving toward a “Clinic First” residency paradigm. Clinic First means that primary care ambulatory resident education assumes equal or greater importance than inpatient resident education and that primary care residency teaching clinics will strive toward more patient-centered care. To move toward a Clinic First orientation, CEPC has developed the Building Blocks model for high-performing teaching clinics (see cepc.ucsf.edu to download the High-Functioning Residency Clinics Report published with the Association of American Medical Colleges).
Why Clinic First?
Family medicine clinics training future primary care physicians face significant challenges. Faculty physicians and residents may spend only 1 – 3 half-days per week in clinic, creating obstacles for continuity, access, and team based care. Disorganized clinic experiences lead to low clinician and staff satisfaction, and can cause trainees to abandon plans for careers in primary care. The Clinic First paradigm provides a roadmap for synergistically fulfilling both missions of education and patient care in a way that invigorates the current and future workforce in primary care.
What does the collaborative involve?
The collaborative will start with a 1 ½ day face to face meeting in Kansas City, Missouri on February 26-27, 2018. This will be followed by 6-8 interactive videoconferences over the subsequent 10 months that will include presentations and discussions about the Building Blocks and practical strategies for implementing Clinic First principles. The participating programs will identify the specific Building Blocks and Clinic First principles to prioritize for the collaborative (such as data-driven improvement, empanelment, team-based care, access, continuity of care, resident scheduling, or resident engagement). Examples of best practices from residency programs and teaching clinics that have successfully implemented Clinic First elements will be a prominent part of the collaborative learning. CEPC staff will also be available for up to 4 hours of individualized coaching by phone or e-mail for each participating residency program.
What will be required of participating programs?
Each residency program will select up to 3 people to participate, ideally a residency director, clinic medical director, and resident. The collaborative will expect consistent participation of these individuals in all learning sessions.
Participants will not be required to submit detailed, repeated reports on metrics though it will be recommended that they track a limited set of relevant metrics to assess their progress on their priority Building Block goals. Collaborative partners will be expected to complete a baseline self-assessment of their clinic using the Building Blocks Primary Care Assessment tool and repeat this self-assessment at the end of the collaborative. Programs will also be expected to answer a few questions at the end of the collaborative that qualitatively assess their perception of successes and challenges in making progress on the collaborative’s goals. Some programs may be asked to write some blog-like messages to share their experience and/or to present their experience at the 2019 Program Directors Workshop.
For attendance at the face to face meeting in February 2018, AFMRD will reimburse a total of up to $3,000 in travel/hotel/meal expenses (with receipts) for each program. This should cover attendance costs for 2-3 members of the program’s team. Any expenses incurred beyond $3,000 would be up to the participating program to provide.