Implementing the patient-centered medical home in residency education.
BACKGROUND
In recent years, physician groups, government agencies and third party payers in the United States of America have promoted a Patient-centered Medical Home (PCMH) model that fosters a team-based approach to primary care. Advocates highlight the model's collaborative approach where physicians, mid-level providers, nurses and other health care personnel coordinate their efforts with an aim for high-quality, efficient care. Early studies show improvement in quality measures, reduction in emergency room visits and cost savings. However, implementing the PCMH presents particular challenges to physician training programs, including institutional commitment, infrastructure expenditures and faculty training.


CONCLUSIONS
Teaching programs must consider how the objectives of the PCMH model align with recent innovations in resident evaluation now required by the Accreditation Council of Graduate Medical Education (ACGME) in the US. This article addresses these challenges, assesses the preliminary success of a pilot project, and proposes a viable, realistic model for implementation at other institutions.
Department of Internal Medicine and Pediatrics, Yale University School of Medicine, New Haven, Connecticut, USA.
Benjamin R
BR
Doolittle
Daniel
D
Tobin
Inginia
I
Genao
Matthew
M
Ellman
Christopher
C
Ruser
Rebecca
R
Brienza
D000068:Accreditation / Q000592:standards; D003237:Connecticut; D004503:Education, Medical, Graduate / Q000458:organization & administration* / Q000592:standards / Q000639:trends; D006787:Hospitals, Veterans / Q000458:organization & administration* / Q000592:standards / Q000639:trends; D006801:Humans; D007396:Internship and Residency / Q000458:organization & administration* / Q000592:standards / Q000639:trends; D007400:Interprofessional Relations; D007857:Leadership; D019982:Organizational Case Studies; D010348:Patient Care Team / Q000458:organization & administration* / Q000592:standards / Q000639:trends; D018802:Patient-Centered Care / Q000458:organization & administration* / Q000592:standards / Q000639:trends; D016730:Program Development / Q000379:methods; D014481:United States