Introduction: A significant number of family medicine faculty and residents describe practicing in their residency clinics negatively. Faculty are often part time ambulatory clinicians with academic interests that conflict with their clinic duties. Residents are faced with a steep learning curve around the complexity and efficiencies of ambulatory medicine. Both roles must navigate a complex environment of competing priorities in order to provide patients with the best possible care. To do this efficiently, it’s critical that we understand and act on the opportunities, barriers, and drivers within our teams. Aligned with achieving the outcomes of the Quadruple Aim, we identified the need for an evidence-based Joy In Practice (JIP) model with embedded measures to guide improvement.
Setting: The University of Minnesota Medical School has four Family Medicine residency clinics, two in Minneapolis and two in St. Paul. Each residency clinic has 13-19 faculty, 18-24 residents, and 24-42 staff.
Process: A literature review was conducted to identify the key drivers of resident and faculty JIP. Key clinic and program leaders met and collectively reflected on what made a “good day”. A preliminary model was developed, disseminated to leaders across the department, residents and faculty, and modified. Metrics were selected from measures already available and the literature.
Model: The final JIP model consists of 6 components; Clinic As Curriculum (Clinic First), increasing continuity and clinic schedule prioritization; Electronic Health Record (EHR), dissemination of EHR resources and centralized EHR resident curriculum; Visit Efficiency, standard rooming processes; Team Function, local team building initiatives; Time, 30-minute visits; Culture, teaching family medicine values, identity and purpose.
Results: A survey was distributed to faculty, residents and staff at all four clinics in April 2024 and included the Assessment for Collaborative Environments (ACE-15). The response rate was 58%. Responses were positive to a majority of the ACE-15 questions, with faculty tending to be the most positive about the team function and staff the least positive.
Impact: Clinical leaders are often asked by faculty and residents to improve their residency clinic experience. Having a model that drives ongoing improvement projects creates a shared understanding of the drivers of Joy in Practice, demonstrates leadership attention and desire to improve provider experience, and organizes operational attention on literature supported drivers. Team is a core element that requires deliberate measurement and attention.
In support of improving patient care, this activity is planned and implemented by The National Center for Interprofessional Practice and Education Office of Interprofessional Continuing Professional Development (National Center OICPD). The National Center OICPD is accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC) to provide continuing education for the healthcare team.
As a Jointly Accredited Provider, the National Center is approved to offer social work continuing education by the Association of Social Work Boards (ASWB) Approved Continuing Education (ACE) program. Organizations, not individual courses, are approved under this program. State and provincial regulatory boards have the final authority to determine whether an individual course may be accepted for continuing education credit. The National Center maintains responsibility for this course. Social workers completing this course receive continuing education credits.
The National Center OICPD (JA#: 4008105) is approved by the Board of Certification, Inc. to provide continuing education to Athletic Trainers (ATs).
This activity was planned by and for the healthcare team, and learners will receive Interprofessional Continuing Education (IPCE) credit for learning and change.
Physicians: The National Center for Interprofessional Practice and Education designates this live activity for AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with their participation.
Physician Assistants: The American Academy of Physician Assistants (AAPA) accepts credit from organizations accredited by the ACCME.
Nurses: Participants will be awarded contact hours of credit for attendance at this workshop.
Nurse Practitioners: The American Academy of Nurse Practitioners Certification Program (AANPCP) accepts credit from organizations accredited by the ACCME and ANCC.
Pharmacists and Pharmacy Technicians: This activity is approved for contact hours.
Athletic Trainers: This program is eligible for Category A hours/CEUs. ATs should claim only those hours actually spent in the educational program.
Social Workers: As a Jointly Accredited Organization, the National Center is approved to offer social work continuing education by the Association of Social Work Boards (ASWB) Approved Continuing Education (ACE) program. Organizations, not individual courses, are approved under this program. State and provincial regulatory boards have the final authority to determine whether an individual course may be accepted for continuing education credit. The National Center maintains responsibility for this course. Social workers completing this course receive continuing education credits.
IPCE: This activity was planned by and for the healthcare team, and learners will receive Interprofessional Continuing Education (IPCE) credits for learning and change.
Learners can claim CE credit by completing the Daily Evaluation.
