An Organizational Innovation: The Yale Primary Care Residency Program's Experience with a Firm System

Dawn M. Bravata, Stephen J. Huot

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background: Integrated inpatient-outpatient firms developed in residencies with single institutions may not be applicable to residency programs with multiple inpatient and outpatient training sites. Our objective was to develop a firm in a multisite residency program that improved education and patient care. Description: One ward team was restructured into a firm that included two interns, three residents, and four private practice internists whose patients were admitted to the firm. Educational impact, length of stay, hospital charges, and in-hospital mortality were evaluated. Evaluation: The firm experience increased outpatient training, fostered mentoring relationships, and increased attending availability. Mean length of stay (5.7 vs. 6.5 days, p = .2) and mean hospital charges ($10,888 vs. $12,316, p = .8) for firm and nonfirm patients, respectively, were not different. In-hospital mortality was lower for firm patients (9 of 348, 3%, vs. 87 of 1,565, 6%; p = .02). Conclusions: Firm structures with educational and patient care advantages can be instituted in multisite residencies.

Original languageEnglish (US)
Pages (from-to)182-188
Number of pages7
JournalTeaching and Learning in Medicine
Volume14
Issue number3
DOIs
StatePublished - Jan 1 2002

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Organizational Innovation
Internship and Residency
Primary Health Care
innovation
firm
Hospital Charges
Outpatients
Hospital Mortality
Inpatients
Length of Stay
Patient Care
experience
Private Practice
Patient Education
patient care
mortality
mentoring
resident

ASJC Scopus subject areas

  • Education

Cite this

An Organizational Innovation : The Yale Primary Care Residency Program's Experience with a Firm System. / Bravata, Dawn M.; Huot, Stephen J.

In: Teaching and Learning in Medicine, Vol. 14, No. 3, 01.01.2002, p. 182-188.

Research output: Contribution to journalArticle

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