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Scripps Mercy Hospital Continuous Circle of Care

The overall concept: Continuous Circle of Care. Opportunity to improve patient care and improve resident education at every point in the patient-physician encounter Starts with initial encounter between resident and patient: where empathy is established and patient develops confidence in the thera

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Scripps Mercy Hospital Continuous Circle of Care

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    1. Scripps Mercy Hospital Continuous Circle of Care APDIM Meeting, April 6, 2006 David Shaw, M.D., Director of Medical Education Stanley Amundson, M.D., Program Director

    2. The overall concept: Continuous Circle of Care Opportunity to improve patient care and improve resident education at every point in the patient-physician encounter Starts with initial encounter between resident and patient: where empathy is established and patient develops confidence in the therapeutic relationship

    3. The overall concept: Continuous Circle of Care (continued) Circle is complete when patient returns for follow-up At this point resident learns whether he/she has been effective in motivating patient to comply with prescribed, evidence-based diagnostic procedures and therapeutic interventions

    4. The overall concept: Continuous Circle of Care (continued) In between opportunity to improve patient care and resident education in a measurable fashion at each intervening point in circle: history, physical exam, formulation of problem list, selection of diagnostic tests, creation of differential diagnosis resolved to highest level, development of therapeutic plan, education of patient about diagnosis and therapies, integration of patient safety into processes of care, and timely and cost-effective provision of services

    5. Low-Tech Example of the Continuous Circle of Care The Cardiac CEX: Used to measurably improve physical examination and ensure accurate diagnosis, improving patient care

    6. Background Studies continue to show that 70% of our diagnostic medical information comes from a well-performed history and physical examination. Studies also show that current United States Residents miss 50% or more of significant cardiac physical exam findings. The physical exam is cost effective, non-invasive and it enhances the doctor patient relationship. A structured Cardiac CEX can evaluate and teach cardiac physical exam skills while the patient is being staffed, which is time efficient.

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