Family Medicine “D” Service: Built to Deliver In Every Way Jessie Flynn, MD; Valerie King, MD, MPH; Scott Fields, MD Department of Family Medicine, Oregon Health & Science University Goals Curriculum Structure Outcomes 2006 Ensure patient safety and high quality care Continuous educational improvement Built on prior successes Maximize maternity care continuity Robust and supportive maternity care curriculum 4 week block rotations 3 months on “D” Service during residency 1 month in PGY-1 year 2 months in PGY-2 year Service rounds and L&D coverage Dedicated “Nightfloat” for L&D 388 vaginal deliveries 97 Cesarean deliveries Average PGY-3 deliveries: 60 7/12 grads do maternity care 2/12 grads have C/S privileges Resident Views Whom do we serve? “Excellent experience in basic prenatal care” “Excellent to work with our own faculty doing obstetrics” “D service is excellent, lots of learning not covered in OB or Peds” 4 Family Health Centers 1 FQHC, 1 RHC, 2 OHSU community clinics 1 County health department clinic 800 admissions per year 2006 Increased from 480 in 2005 Educational Environment Resident & faculty pairs for continuity prenatal care Senior residents learn supervisory role at births Students participate in continuity PNC Structured weekly didactics Operative delivery training option for PGY-3s NICU admitting privileges ALSO and NRP training Collegial and constructive outside relationships Future Directions Challenges Formal training in OB US Group prenatal care Improved patient tracking and QI with electronic health record Expanded reproductive health curriculum Urban University tertiary care hospital Continuity of care for women and residents Learning environment for residents and faculty