There’s no I in team: Clinic (practice) improvements based on resident feedback!

1. There’s no I in team: Clinic (practice) improvements based on resident feedback!

2. CONTINUITY!!! • TEAM Follow up (applies to all) • Special Sessions (PGY3’s) • PLANNED VISITS (PGY2 and PGY3’s)

3. My patient needs a quick follow-up…but I am starting night float!

4. Team follow-up sessions Do you have a patient with a form that needs to be completed soon? A patient who needs a quick B/P check? A patient who needs sooner follow-up to review lab results? If you have no available appointments, use the Team Follow-up session. Each team will have 2 sessions/month that can be booked only with that team’s follow-up patients—patients who need a quick, focused visit.

5. Level of Care for team follow-up Document exactly what needs to be done with your patient. The team resident does only what you indicated—not a comprehensive visit, but rather a focused visit. For Z-outs, this will likely be a level 3 visit Send a short email to the referring colleague, if indicated. For example—”Mr. Lee’s B/P=134/70; he is tolerating dyazide well.”

6. I’m a PGY-3 and I don’t have enough clinic slots to see my patients…what can I do?

7. PGY-3 Special Sessions • Each PGY-3 will have one session/month that only he/she can book patients into. This will make it possible for you to follow your own patients. • There will be 6 slots initially, increasing to seven in Jan 2012. • This dedicated follow-up session should obviate the need to overbook.

8. This patient needs more than 15 minutes…how can I take better care of her?

9. The Planned Visit • You’ll see two patients in the session and you’ll choose them yourself • Good choices might be patients with poorly controlled chronic conditions, poor compliance with medications, psychiatric disease, frequent ED flyers, etc… • These will not be in the booking schedule! • Let the front desk Associates and your PCA’s you are expecting patients!

10. Important Tidbits of Info Booking will be a three step process (not planned visits): First, check AMION for the dates and times of these special sessions Tell the patient when to come back Send an email on Outlook to: APCS ACM with the patient’s MR number and telephone number.

11. Can you view future booking? Sure! Ask any PCA or clerical person to show you the availability of these special sessions. It takes a few minutes, so try to pick a time when the staff isn’t busy. They are willing and able to help you.

12. Caveats…. • You can see other/additional patients if your Special Sessions, Team Follow ups or Planned visits are not booked and confirmed or are NO-SHOW • Planned visits should be confirmed by you!!! • Make a note in “other contact” • Booking Associates will check your panel the night before to identify any unused/unconfirmed/open slots that can be used for refills or overflow….

13. Pitfalls/Troubleshooting • No special sessions in the schedule… • Special sessions are already booked… • Special sessions are incorrectly booked… • Nobody seems to know what you are talking about… • Let a manager know what is going on!

14. Clinic Basics

15. Walk in closes for lunch at 12:15. Tell the DT and the PCA if any charts are still on your door. • If you are on call you are expected to see no more than three patients (two for PGY-1’s) and to finish by 3:00. • In regular clinic PGY-1’s should see four patients; PGY-2’s six; PGY-3’s seven. • If a patient is more than 30 minutes late please discuss this with a DT. (Asking the patient to re-schedule is an option.)

16. In the morning, clinic starts at 8:30 and ends at 12:15. In the afternoon, it starts at 1:15 and ends at 4:30ish. • Please sign in. • Let the DTs know if you start falling behind. They are here to help. • If you see a DT unavailable, please do not hesitate to say: “Hi—I need to present a case!”