title: The ambulatory long-block: an accreditation council for graduate medical education (ACGME) educational innovations project (EIP).
abstract: BACKGROUND
  Historical bias toward service-oriented inpatient graduate medical education experiences has hindered both resident education and care of patients in the ambulatory setting.
  
  
  OBJECTIVE
  Describe and evaluate a residency redesign intended to improve the ambulatory experience for residents and patients.
  
  
  METHODS
  Categorical Internal Medicine resident ambulatory practice at the University of Cincinnati Academic Health Center.
  
  
  METHODS
  We created a year-long continuous ambulatory group-practice experience separated from traditional inpatient responsibilities called the long block as an Accreditation Council for Graduate Medical Education Educational Innovations Project. The practice adopted the Chronic Care Model and residents received extensive instruction in quality improvement and interprofessional teams.
  
  
  RESULTS
  The long block was associated with significant increases in resident and patient satisfaction as well as improvement in multiple quality process and outcome measures. Continuity and no-show rates also improved.
  
  
  CONCLUSIONS
  An ambulatory long block can be associated with improvements in resident and patient satisfaction, quality measures, and no-show rates. Future research should be done to determine effects of the long block on education and patient care in the long term, and elucidate which aspects of the long block most contribute to improvement.
authors.affiliation: Department of Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, USA. warmej@uc.edu
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Warm
authors.forename: Daniel P
authors.initials: DP
authors.lastname: Schauer
authors.forename: Tiffiny
authors.initials: T
authors.lastname: Diers
authors.forename: Bradley R
authors.initials: BR
authors.lastname: Mathis
authors.forename: Yvette
authors.initials: Y
authors.lastname: Neirouz
authors.forename: James R
authors.initials: JR
authors.lastname: Boex
authors.forename: Gregory W
authors.initials: GW
authors.lastname: Rouan
mesh_terms: D000068:Accreditation; D000553:Ambulatory Care; D004503:Education, Medical, Graduate; D006801:Humans; D007388:Internal Medicine / Q000193:education*; D007396:Internship and Residency / Q000458:organization & administration*; D011787:Quality of Health Care