title: Addressing outpatient continuity for ambulatory training: A novel tool for longitudinal primary care sign out.
abstract: BACKGROUND
  We created a tool to improve communication among health professional trainees in the ambulatory setting. The tool was devised to both inform practice partner teams about high-risk patients and assign patient follow-up issues to team members. Team members were internal medicine residents and nurse practitioner fellows in the VA Connecticut Healthcare System Center of Excellence in Primary Care Education (CoEPCE), an interprofessional training model in primary care.
  
  
  METHODS
  We used a combination of Likert scale response questions and open ended questions to evaluate trainee attitudes before and after the implementation of the tool, as well as solicited feedback to improve the tool.
  
  
  RESULTS
  After using the primary care sign out tool, trainees expressed greater confidence that they could identify high-risk patients that had been cared for by other trainees and that important patient care issues would be followed up by others when they were not in clinic. In terms of areas for improvement, respondents wanted to have the sign out tool posted online.
  
  
  CONCLUSIONS
  Our sign out tool offers a strategy that others can use to improve communication and knowledge of shared patients within teams comprised of interprofessional trainees.
authors.affiliation: Center of Excellence in Primary Care Education, West Haven; Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA.
authors.forename: Theodore
authors.initials: T
authors.lastname: Long
authors.forename: Andrea
authors.initials: A
authors.lastname: Uradu
authors.forename: Ronald
authors.initials: R
authors.lastname: Castillo
authors.forename: Rebecca
authors.initials: R
authors.lastname: Brienza
mesh_terms: D000553:Ambulatory Care / Q000458:organization & administration* / Q000592:standards; D003142:Communication; D003266:Continuity of Patient Care / Q000458:organization & administration* / Q000592:standards; D006801:Humans; D007388:Internal Medicine / Q000193:education*; D007396:Internship and Residency / Q000458:organization & administration / Q000592:standards; D007400:Interprofessional Relations; D010348:Patient Care Team / Q000458:organization & administration* / Q000592:standards; D062209:Patient Handoff / Q000458:organization & administration* / Q000592:standards; D011320:Primary Health Care / Q000458:organization & administration* / Q000592:standards