Cllege f Ostepathic Medicine MEDICAL HOME CLERKSHIP Bradlawns Medical Center J. Stubblefield D.O. Faculty, Bradlawns Family Health Center 515-282-2397 Elective Rtatin GENERAL DESCRIPTION This furth-year student elective rtatin is a fur week experience in a medical hme clerkship and is intended t be a structured clinical and crdinated care experience under direct supervisin. This rtatin is a time t gain a basic understanding f the varius aspects f a medical hme as it pertains t enhanced patient care in the primary care setting. A grade fr the rtatin will nt be given, r psted t the student transcript until all pst rtatin paperwrk and requirements are cmpleted and received in the DMU Office f Clinical Affairs. N pst-rtatin written examinatin is required fr this rtatin. Purpse In 1991, the Institute f Medicine identified the pr quality f care in the current healthcare system and called fr refrm. The Medical Hme has becme the new mdel f care t imprve patient utcmes and decrease wasteful spending. The Medical Hme is cmprised f many innvative cmpnents frm imprving patient access, chrnic disease registries, crdinated care, and electrnic health recrds. There is n frmal training f this new mdel in the current medical schl training. This rtatin will prvide a hands-n intrductin t the Medical Hme and what is shaping up t be the future f primary care. This will prvide students with the pprtunity t learn abut the Medical Hme and its varius aspects prir t chsing a specialty and entering pst-graduate training.
COURSE OBJECTIVES General Overview We recgnize that fur weeks is an insufficient time t cver a cmprehensive list f bjectives; hwever, by the end f this rtatin the student shuld be able t: Discuss the current landscape f healthcare refrm regarding the Medical Hme and the future directin f primary care. Identify and discuss the varius criteria f a Medical Hme and hw they pertain t imprved patient care. Access Write a plicy that details a clinical prcess pertinent t a Medical Hme. Discuss clinic plicies and practices and hw t prevent ER visits and hspitalizatins thrugh imprved patient access. Outline a prcess imprvement prject. Chrnic Disease Management Discuss the main capabilities f a chrnic disease registry and hw they pertain t imprved utcmes and ppulatin medicine. Generate fur different types f reprts frm a chrnic disease registry. Identify the current standard f care (benchmarks, testing, and screening) fr the fllwing diseases: Diabetes, Asthma, COPD, Depressin, Chrnic Pain. Apply knwledge f the current standard f care fr varius chrnic diseases thrugh phne visits, pre-visit chart reviews, and face t face visits under direct supervisin. Outline a quality imprvement prject Preventative Medicine Identify the current standard f care (screening, immunizatins, and risk assessments) fr general health maintenance and preventative medicine. Apply knwledge f the current standard f care fr preventative medicine thrugh phne visits, pre-visit chart reviews, and face t face visits under direct supervisin. Referral Tracking Discuss the imprtance f referral tracking as it pertains t the Medical Hme Maintain a referral tracker tickler file. Electrnic Health Recrd
Identify the ptential capabilities f an Electrnic Health Recrd (EHR) as it pertains t a Medical Hme. Implementatin Curse bjectives are t be met in the Bradlawns Family Health Center, under supervisin. Basic bjectives must be cvered during the rtatin t assure adequate student preparatin fr bard examinatins, pst-dctral training and independent patient care. The use f diverse methds apprpriate t the clinical site will be utilized, but patient-centered teaching will be the main fcus. Didactic methds t achieve required bjectives include: Reading assignments Medical Hme Overview Orientatin Student assigned lectures Cmputer-assisted prgrams Clinical Prcesses methds include: Clinical Prcesses Overview Tracking f same day visits, cancellatins, and n shws Develping a Prcess Imprvement prject utline Writing a clinic plicy pertaining t the Medical Hme Managing a referral tracking system Patient management methds include: Chrnic Disease Registry Overview Use f the fur types f Chrnic Disease Registry reprts: Pint f care patient summary reprt, Prvider prgress reprt, Exceptin reprt, Stratified ppulatin reprt Pre-visit chart bipsies with a weekly emphasis n a different chrnic disease and its standard f care recmmendatins Participate in clinic visits pertaining t the chrnic disease f the week and utilize the patient summary reprt at the pint f care t educate the patient. Generate a prvider prgress reprt fr resident physicians and faculty and discuss benchmarks fr quality care within a ppulatin. Generate a stratified ppulatin reprt t identify a specific ppulatin fr targeted imprvement. Outline a quality imprvement prject targeted at a specific ppulatin Generate an Exceptin reprt t identify ppulatins due fr services and cntact these patients fr scheduling r educatin. Gals and AOA Cmpetiencies Patient Care- Students shuld be able t prvide patient care that is cmpassinate, apprpriate, and effective fr the treatment f health
prblems and the prmtin f health. Students shuld be expected t: Educate patients regarding their health care Participate in the care f patients in the clinical setting Medical Knwledge- Students must demnstrate knwledge f established and evlving bimedical, clinical, epidemilgical, and scial-behaviral sciences, as well as the applicatin f this knwledge t patient care. Students are expected t: Demnstrate knwledge f the basic science principles necessary t understand the clinical aspects f disease. Understand and explain the pathphysilgy, clinical manifestatins, and treatment ptins fr the cmmn diseases seen by medical hme prviders. Practice-Based Learning and Imprvement-Students must demnstrate the ability t investigate and evaluate the care f patients, t appraise and assimilate scientific evidence, and t cntinuusly imprve patient care based n cnstant self-evaluatin and life-lng learning. Students are expected t develp skills and habits t be able t: Identify and perfrm apprpriate learning activities Lcate, appraise and assimilate evidence frm scientific studies related t their patients health prblems Systems Based Practice- Students must demnstrate an awareness f and respnsiveness t the larger cntext and system f health care, as well as the ability ft call effectively n ther resurces in the system t prvide ptimal health care. Students are expected t: Wrk effectively in varius health care delivery settings and systems Crdinate patient care within the health care system Prfessinalism- Students must demnstrate a cmmitment t carrying ut prfessinal respnsibilities and an adherence t ethical principles. Students are expected t demnstrate: Cmpassin, integrity, and respect fr thers Sensitivity and respnsiveness t a diverse patient ppulatin, including but nt limited t diversity in gender, age, culture, race, religin, disabilities, and sexual rientatin Interpersnal and Cmmunicatin Skills- Students must demnstrate interpersnal and cmmunicatin skills that result in the effective exchange f infrmatin and teaming with patients, their families, and prfessinal assciates. Students are expected t: Cmmunicate effectively with patients and families acrss a brad range f sciecnmic and cultural backgrunds
Cmmunicate effectively with physicians, ther health care prfessinals, and health related agencies Ostepathic Practice and Principles Students must demnstrate the skills and knwledge t knw what stepathic principles and techniques are, and are nt apprpriate. Students are expected t: Perfrm an apprpriate structural evaluatin. Outline a plan f treatment utilizing the apprpriate mdality (HVLA, muscle energy, facilitated release, Still techniques, etc). Carry ut the treatment under supervisin. Evaluatin f the student must be cmpleted within ne week f the cmpletin f the rtatin, and can be dne n-line via E*Value. On the last day f service, the supervising physician shuld review the student s perfrmance with the student. It is als highly recmmended that the student ask fr, and receive, nging perfrmance feedback thrughut the rtatin; althugh mst f the time this will be verbal and nt in written frm. Required Assigned Articles: REQUIRED READING Chrnic Disease Registries: A Prduct Review; Prepared by NAS Cnsulting Services, May 2004. Crssing the Quality Chasm: A New Health System fr the 21 st Century, Institute f Medicine Cnsensus Reprt, Mar 2001. The Future f Family Medicine: A Cllabrative Prject f the Family Medicine Cmmunity; Future f Family Medicine Prject Leadership Cmmittee; Annals f Family Medicine, 2:S3-S32, 2004 Chrnic Cnditins: Making the Case fr Onging Care; Andersn, G., et al., Partnership fr Slutins, Jhns Hpkins University, Dec 2002 Creating a Lean Practice; Endsley, S., et al., Family Practice Management, 13(4):34-38 Apr 2006, Quality Imprvement: First Steps; Cleman, M. and Endsley, S., Family Practice Management, Mar 1999.
ATTENDANCE POLICY Each student is expected t be in attendance and participate as per the COM Clinical Rules and Regulatins. Jan 5, 2011; dcs