title: Improved continuity of care in a resident clinic.
abstract: BACKGROUND
  For residents in the out-patient clinic, continuity in patient care is an integral and vital aspect of internal medicine training, but is frequently compromised by resident in-patient schedules, the structure of the out-patient clinic and the need to comply with the increasing regulation of duty hours.
  
  
  METHODS
  In this study, we examined whether the creation and implementation of a new team approach, the Firms Model, would improve the continuity of patient care in the internal medicine resident out-patient clinic.
  
  
  RESULTS
  Before the implementation of the Firms Model, an examination of a consecutive clinic sample indicated that patients were seen by their assigned resident providers 41.9 per cent of the time (n = 1319 clinic visits). After implementation of the Firms Model, an examination of a consecutive clinic sample indicated that patients were seen by their assigned Firm resident providers 88.9 per cent of the time (n = 1341 clinic visits).
  
  
  CONCLUSIONS
  Implementation of the Firms Model resulted in a statistically significant increase in the percentage of patients seen by assigned resident providers in an internal medicine out-patient clinic, culminating in a substantial improvement in continuity of care within our resident out-patient clinic. We discuss the implications of these findings. Continuity in patient care is an integral and vital aspect of internal medicine training, but is frequently compromised.
authors.affiliation: Department of Internal Medicine, Kettering Medical CenterDayton, Ohio, USA.
authors.forename: Melissa
authors.initials: M
authors.lastname: Butler
authors.affiliation: Department of Internal Medicine, Kettering Medical CenterDayton, Ohio, USA.
authors.forename: Hyungkoo
authors.initials: H
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Kettering Medical CenterDayton, Ohio, USA.
authors.forename: Randy
authors.initials: R
authors.lastname: Sansone
mesh_terms: D000328:Adult; D003266:Continuity of Patient Care / Q000592:standards; D005260:Female; D006801:Humans; D007388:Internal Medicine / Q000193:education; D007396:Internship and Residency / Q000458:organization & administration / Q000592:standards; D008297:Male; D010044:Outpatient Clinics, Hospital / Q000458:organization & administration / Q000592:standards; D010348:Patient Care Team / Q000458:organization & administration; D058996:Quality Improvement / Q000458:organization & administration