Four Peas In A Pod A Team Approach to Patient Care Stacey Nickoloff D.O., Rujuta Gandhi, M.D., Mussarat Bukhari M.D., Elyas Parsa D.O., Munira Bhabhrawala D.O., Patrick Gibbons D.O. Advocate Christ Family Medicine Residency Program  Family Medicine is a challenging field & family physicians are pulled in many different directions while trying to maintain continuous care of our patients.  It is not surprising that an open access form of scheduling (patient seeing any available physician versus their own PCP) naturally starts to develop over time.  As a consequence of an “open access” model, the literature supports the notion that continuity of care and overall quality of care is negatively affected.  The discipline of Family Medicine considers continuity of care of utmost importance.  Given the evidence in the literature and anecdotal experience in the residency setting, the Advocate Christ Family Medicine Residency Program (ACFMRP) looked at strategies to improve continuity of care.  Within the practice, faculty decided to implement small teams of physicians to care for patients rather than a sole provider.  Though a patient will still maintain a PCP, now in addition a small “pod” of physicians will become familiar with and communicate regarding the team’s panel of patients.  Patients will be seen by a member of their treatment pod if their PCP is unavailable.  The authors hypothesize that implementation of this small team intervention will improve continuity of care and overall patient satisfaction. Introduction References 1.Adler R., Vasiladis A., Bickell N. The relationship between continuity and patient satisfaction: a systemic review. Family Practice 2010 Apr 27(2): Salisbury C, Sampson F, Ridd M, Montgomery AA. How should continuity of care in primary health care assessed? BrJ Gen Pract Apr;59(561)ce Lou Wendy W,Y. A New Measure for Continuity of Care: The Alpha Index. Health Services & Outcomes Research Methodology 1:3-4 (2000): Rodriguez HP, Rogers WH, Marshall RE, Safran DG. The Effects of primary care physician visit continuity on patients’ experiences with care. J Gen Intern Med Jun 22(6): Epub 2007 Apr Mainous III A, Salisbury C. Advanced Access, Open Access, and Continuity of Care: Should We Enforce Continuity? Fam Med 2009;41(1): Kraft R, Brown A. All for one, one for all: value of small teams in residency family medicine clinics. Poster session presented at Conference for Practice Improvement sponsored by AAFP, STFM. 2010, Dec. San Antonio, Texas. Methods  This study utilizes both quantitative and qualitative measures.  The quantitative measure is based on calculating the Continuity of Care (COC) Index for each provider. The COC Index is an individual-based measure that takes into account the proportion of consultations with the same doctor, adjusted for the number of consultations.  For each of our 26 physicians, the COC Index will be measured prior to and 6 months and 12 months following implementation of teams.  Given the change in care model, the physician “pod” will be interchangeable with provider in our calculations following small team implementation.  The qualitative assessment will be based on 3 sets of consecutive random surveys measuring patient satisfaction and patient perception of continuity of care.  For each provider, 5 random “continuity” patients (>3 visits in past 6 months) will be surveyed prior to implementation of small team model and 6 months and 12 months following implementation. Results  Data analyses will consist of pre/post comparisons on both quantitative and qualitative measures.  Results will be forthcoming. The Survey Patient Survey At the Advocate Christ Family Medicine Clinic we are always trying to develop new and innovative ways to make sure that the quality of your healthcare is the best that it can be. We would like to create a more consistent and personal experience at the clinic. Specifically, we are developing a TEAMS healthcare approach in which each patient will have a primary doctor and also a small team of physicians that will be familiar with each patient’s medical history and treatment plan. By creating these teams we aim to enhance the patient-physician relationship and continuity of care for all patients in our clinic, while maintaining accessibility to the clinic. We hope that this will create seamless service for YOU the patient so that we can better help you achieve your health care goals. In order to assess the perceived benefits of this team approach, we hope that you will take a few seconds to complete this survey. Thank you for your participation. 1.What degree of trust do you have in your health-care team? (1- not at all, 10- complete trust)         2.I feel “known” by my health care team at the Family Medicine Center? (1- not at all, 10- very well known)         3.How much do you feel that your healthcare has been negatively affected by having different residents see you at the Family Medicine Clinic? (1- not at all, 10- very negatively)         4.How satisfied are you with the healthcare you receive at the Family Medicine Center? (1- not at all, 10- completely satisfied)         5.How likely are you to recommend this practice to your family and friends? (1- not at all likely, 10- extremely likely)        