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The Continuum of a Primary Care Service Infrastructure and the Development of a Community Pediatrics Program

The Continuum of a Primary Care Service Infrastructure and the Development of a Community Pediatrics Program Matilde Irigoyen, Dodi Meyer, and Mary McCord Columbia University, NY Columbia University Department of Pediatrics Tertiary care center Generalist faculty: 25 FTE 60 residents:

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The Continuum of a Primary Care Service Infrastructure and the Development of a Community Pediatrics Program

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  1. The Continuum of a Primary Care Service Infrastructure and the Development of a Community Pediatrics Program Matilde Irigoyen, Dodi Meyer, and Mary McCord Columbia University, NY

  2. Columbia University Department of Pediatrics • Tertiary care center • Generalist faculty: 25 FTE • 60 residents: • more than half enter specialties

  3. The Community • Demographics: Latino and African American • Assets: vibrant Community-Based Organizations • Needs: High levels of poverty, poor schools, injuries, and domestic violence

  4. Community-based Primary Care: Service Infrastructure • Model: the General Pediatrics Group Practice • Decentralized primary care • Integrated resident – faculty practices

  5. General Pediatric Group Practice: Service • 16,000 children/year • 60,000 visits, scheduled and walk-ins • Special health care needs children • 24 hour coverage – 7 days/week • Inpatient coverage

  6. General Pediatric Group Practice: Education • Leadership roles • Main preceptors for residents and medical students in: • Continuity clinic • Ambulatory block • Inpatient wards

  7. Community Pediatrics:Beyond Hospital Walls • Reverses community-hospital relationship • Moves away from hospital’s institutional culture • Promotes knowledge of community resources • Facilitates collaboration with community

  8. Community-based Education: Service Learning • Structured educational methodology • Combines community service with specific goals and objectives • Integrates community members as active partners in program design, implementation and evaluation

  9. Community-based Education for Residents: Examples • School health clinic • Newborn home visitation program

  10. Decentralized Primary Care:Pros • Fosters mentoring of residents • Allows independence and creativity of faculty and sites • Closeness to community and Community-Based Organizations

  11. Decentralized Primary Care: Challenges • Maintaining standards and a unified vision • Decentralized faculty and residents: logistical difficulties

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