PubMed · 6899156
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1980-02-14. Continuing care: working together.. https://pubmed.ncbi.nlm.nih.gov/6899156/
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BACKGROUND: The pediatric residency program at the University of Massachusetts Medical Center, Worcester, has based its continuity experience in community practices since 1988. Residents develop a relationship not only with their patients but also with the preceptors, with whom they are paired one-on-one, and with office staff. OBJECTIVE: To describe the structure and results of an educational program that was developed to address the termination issues that arise at the end of residency. The educational program consists of four components: (1) a seminar, (2) a "mini-block" rotation, (3) office staff involvement, and (4) a resident-preceptor dinner. RESULTS: The following issues and themes have been recurrent in the discussions during the past 4 years: (1) the importance, for patient and resident, of identifying who will be the subsequent health care provider for the patient; (2) the inability to identify which patients had strongest attachment to residents; (3) parental surprise about the resident's departure, even though all parents had been told that the resident was going to be in the practice for only a limited period; (4) the desire of residents to have follow-up on patients after termination; (5) critical aspects of the process of informing patients about the resident's departure; (6) the importance of identifying and addressing the attachment of the resident to the preceptor and office staff, as well as to patients; and (7) the affirming experience that the termination sessions with the patients can be for the residents. CONCLUSION: Although the termination process is potentially emotionally difficult, it can be a personally and educationally valuable experience for residents.
1. Inpatient nurses can help create a seamless health care system by designing groups and specific interventions that begin at the time of admission and continue after discharge. 2. Inpatient nurses must clearly articulate how they intervene for the benefit of patients and how they engineer the coordinated staff effort that maintains the basic safety and structure of the environment. 3. Nurses should learn how to organize and report observations so they formulate a concise assessment summary while also collecting data that are useful to the unit's outcome evaluation.
OBJECTIVE: To investigate the impact of an alternative prenatal care program for low-risk patients. STUDY DESIGN: Five hundred forty-nine low-risk pregnant women were allocated to the study and control groups. The study group received, on average, eight visits, all of them with one of nine study providers. Each study visit had specific objectives and accompanying targeted patient education handouts. The control group received the usual prenatal care (on average, 13 visits) with different providers, according to the customary schedule. RESULTS: There were no significant pregnancy outcome differences between the groups. The study vs. control group differed significantly (P < .0001) in patient satisfaction regarding the number of prenatal visits. There was a higher level of satisfaction in the study group concerning continuity of care (P < .0001). The alternative prenatal care program reduced the number of prenatal visits by 27% and was not associated with any change in maternal or perinatal outcomes. Patient satisfaction parameters were either maintained or improved with alternative prenatal care. CONCLUSION: An alternative prenatal care program for low-risk patients reduced resource utilization without adversely affecting prenatal care process variables, pregnancy outcome or patient satisfaction.