Conference on Practice Improvement December 3-5, 2015 Family Medicine for America's Health Partnering to Develop the Family Medicine Workforce We Need Christina Kelly, MD, FAAFP Conference on Practice Improvement December 3-5, 2015  

Objectives: Learn about the work being done by the FMAHealth and how that applies to practice improvement. Discuss what additional training is needed to prepare future family physicians to work and excel in a PCMH model. Assess how each participant can make a positive impact on expanding our family medicine workforce.

A word about Family Medicine for America’s Health The goal of FMAHealth is to transform primary care in order to achieve the quadruple aim by… …engaging all stakeholders to move America to a high value system of health and health care… …through practice transformation and… …improved financial investment in primary care needed to support it… …with the workforce, technology and research needed to implement and sustain it.

FMAHealth goal achieved through two integrated, multi-year efforts Strategy Implementation Communication Campaign Practice Payment Workforce Technology Research Engagement

What is the work of the six Tactic Teams? Work with patients and other primary care professionals to improve the value—and extol the benefit—of primary care. Build a practice transformation framework that meets family physicians where they are and helps them get ready for the value-based world on the horizon. Practice Practice Engagement Engagement Payment Payment Galvanize the research community to demonstrate primary care’s ability to meet the Triple Aim. Help physicians, patients, and payers get ready for comprehensive payment for primary care, a payment method that best supports primary care. Research Research Workforce Workforce Asking chapters to provide research—what are thye awae of that demonstrates pimary care. Creating collaborations across pbrns. Technology Technology Build a vision for primary technology in the value-based world and go to work on the barriers to getting there. Increase medical student choice of family medicine; recruit, retain, and develop faculty and preceptors.

Focus of Workforce Education and Development Tactic Team Improve the evaluation of the full continuum of family medicine education Increase student choice of family medicine Build a diverse workforce that addresses health disparities Increase the strength, impact and prosperity of family medicine departments and residency programs through recruitment, development and retention of faculty and preceptors Tactic W1: Improve the evaluation of the full continuum of family medicine education to include and meet the standards of the EPAs Tactics W3: Increase medical students' choice of family medicine through multiple strategies, including enhanced resident and faculty mentoring, with a specific emphasis on building a diverse workforce that addresses health disparities Tactic W4: Increase the strength, impact and prosperity of family medicine departments and resident programs through recruitment, development and retention of faculty and preceptors, and provide support to enhance their value in their communities and their institutions

Entrustable Professional Activities Broad categories of activities that define the essential professional work of a discipline Expectations for the education of family physicians Knowledge, skills, and attitudes that resident physicians must must before they graduate Elements that experts and society consider to belong to that specialty EPAs are the critical activities that constitute a specialty, and the elements that experts and society consider to belong to that specialty. EPAs are observable and measurable, lead to recognized outcomes, require integration of competencies across domains, and map to competencies and their Milestones EPAs define the knowledge, skills, and attitudes that resident physicians must have before they graduate.  EPAs are a way to translate the core competencies into the well-defined activities that physicians are expected to do as part of their practice of medicine.

EPAs that relate to practice

Small Group Exercise Divide into Small Groups Groups of 6 or less Combine people in different career stages Read Scenario for Small Group Discussion

Summary of Lucy Strong, smart resident with leadership potential Objective measurements in residency didn’t support her skill level Trained in a PCMH After graduation, employed physician in a PCMH Transition to practice was stressful Additional stress with being expected to lead a clinic team

Small Group Discussion 5-10 min How did Lucy’s residency training prepare her for practice? Where did her residency training fall short? Are residents who complete their residency in a PCMH recognized residency practice necessarily prepared to practice in and/or lead a PCMH?

Small Group Discussion Discuss for 10 min and prepare for report back In order for Lucy to feel more prepared to work effectively in a PCMH and lead a team, what are the necessary additions in her residency curriculum and clinic experience?

Small Group Discussion Discuss for 10 min and prepare for report back How could FMAHealth help residencies to consistently provide this training?

If you would like to get engaged with FMAHealth, please visit our Engagement Portal. We get to learn about you You get to learn about FMAHealth You can let us know what parts of FMAHealth interest you and what role you see yourself playing in the strategy implementation http://tinyurl.com/nkrwanz