Summer 2011

Strengthening Partnerships With Primary Care Physicians

In keeping with a nationwide focus on improving care coordination and transitions, pediatric residents at UCSF Benioff Children's Hospital have created an incentive program to tighten communication between the hospital and patients' primary care physicians.

Robin Horak, M.D., one of the residents spearheading the program, said, "We also hope to use the program to help patients understand the importance of seeing a primary care doctor regularly,"

Communication, Coordination

The program emerged from quality improvement processes in place at UCSF that include asking residents to create department-specific initiatives each year to improve quality and safety of care. For 2010-2011, pediatric residents focused on improving the rate of flu shot administration, and are on track to achieve their goals. In the course of implementing that initiative, residents found gaps in the documentation of patients' primary care physicians (PCPs).

Robin Horak, M.D."Not having these records on file decreases the chance of coordinating a patient's care with the PCP," Horak said. "In addition, we found that some chronically ill patients are not seeing a PCP at all. That's not ideal care because there are so many important health issues that are not being covered by a specialist."

Documenting the PCP is not the end goal, of course, just the most measurable one. If residents meet a 95 percent threshold for documentation, they receive a small financial reward. The larger goal, however, is to use the documentation to increase communication with PCPs at both admission and discharge. "We also can try to either help patients set up a visit after discharge or, if the patient does not have a PCP, help the family find one," Horak said.

Glenn Rosenbluth, M.D.Glenn Rosenbluth, M.D., a pediatric hospitalist who co-directs the pediatric residency program, said, "We see this and other efforts we have in place as a way to extend the medical home model to inpatient care. We want to make sure PCPs get whatever information they need, and that they feel comfortable calling our pediatric hospitalists at any time through UCSF's Access Center, (877) UC-CHILD" or (877) 822-4453.

Preparing Residents

Rosenbluth said UCSF is committed to addressing what many believe is an essential element in improving health care — stronger partnerships between hospitals and community physicians. "We want our residents to be fully prepared for these changes," he said.

Horak agrees. "Coordinated care is a priority for us, and we want to use this program not just to communicate more closely with PCPs, but to make sure that patients have a PCP and that they see them regularly," she said.

For more information, contact Dr. Rosenbluth at (415) 476-9185 or Dr. Horak at (415) 476-5001.

Summer 2011 Table of Contents

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