Specialized Medical Residency Rotation Requirements

Some Suggestions Darcy s Way Cheryl s Way Annette s Way

Darcys Way FMC Patient encounters PGY 1 have 2 clinics per week PGY 2 have 4 clinics per week PGY 3 have 6 clinics per week 165 MUST BE 60 OR OLDER 165 MUST BE 10 OR YOUNGER Total encounter 1650 EHR INPATIENT 4 months Inpt PGY 1 2 months Inpt PGY 2 1 month Inpt PGY 3 600HRS/SIX MNS AND 750 ENCOUNTERS EHR ICU patients 1 month ICU rotation 100 hours/ 1 month OR 15 ICU patient encounters Online Mgmt Software by logged hours ED Adult patient encounters 200 Hours 24 Hours in Acute Care month 176 Hours during ED rotation 200 hours/ 2 months OR 250 Adult ED patients Online Mgmt Software by logged hours GERIATRICS 1.5 months of Geri rotation 100hours/ 1month OR 125 Older patient encounters Online Mgmt Software Logged Nursing Home visits PEDIATRIC Inpatient encounters: 1 month PEDS Inpatient rotation PEDS ED is part of ED rotation 200hours/ 2months AND 250 ill child encounter 75 Inpatient 75 ED EHR PEDIATRIC Outpatient encounters: 1 month PEDS outpatient rotation Resident FMC patients EHR 200 hours/2months OR 250 Child/Adolescent ambulatory setting encounters Newborn patient encounters 1 month new born nursery rotation 40 Newborn, pts. including well and ill (3% ill) EHR

Surgical Patient encounters PGY 2 surgical rotation - work with DOC of the week in hospital o Primarily spend time in the OR as first assist for a variety of cases. o Participate in Acute Surgical Patient Evaluations/Consultations. o Participate in inpatient Pre- and Post- Op care Surgical Patient encounters -continued: PGY 3 surgical rotation o 25% Pre- and Post-Op care in clinic o 50% Outpatient Procedures 100 hours/1 month surgical pt. encounters including hospitalized 100 hours/1 month surgical pt. encounters including hospitalized Online Mgmt Software Logging hours Online Mgmt Software Logging hours Sports Medicine/ Musculoskeletal patient encounters PGY 2 and PGY 3 1 month Sports Medicine rotations Gynecology PGY 2 1 month GYN rotation OB patient encounters PGY 1 6 week rotation PGY 2 2 week rotation Plus our program requirement is: 40 non-continuity deliveries 10 continuity deliveries 1. Continuity delivery counts if you deliver the baby 2. If not at delivery you must see baby and mother while they are in hospital and manage post-delivery care. 3. We require this for two reasons: We have a lot of residents interested in OB and the fellowship We fill a need in our community for the adopt a mom program 200 hours/2months Online Mgmt Software Logging hours Online Mgmt Software Logging hours 100 hours/1 month OR 125 Patient encounters Care of women 200 hours/ 2 months dedicated to Prenatal Care, Labor management, delivery system New Innovation document deliveries

Health System Management PGY 3 Community Medicine Faculty are developing a new Practice Management curriculum with a component of Direct Primary Care Online Mgmt Software Logging hours for rotation 100 hours/ 1 month Elective time Online Mgmt Software Tracking hours for rotation Resident schedule Online Mgmt Software enter data in Scholarly activities section PGY 2- I month elective time PGY 3- 2 months elective time 300 hours/ 3months Scholarly Activity 1 QI project - required Journal Club, PEDS presentations, Case conferences 2 NOTES: Encounters: are based on signatures. 2 residents can get credit from one patient encounter. PGY 1 does H&P and signs; UL amends and signs. Both residents get to count this encounter. These encounters are counted in the Department where visit occurred. EHR: writes programs to capture the needed data (typically numbers) so the resident does not have enter the encounter in EHR and then in Online Mgmt Software for tracking. Online Mgmt Software: is used for logging hours, procedures and scholarly activities.

Resident Productivity Provider Notes Encounters 7 68 20 94 49 86 6 17 173 121 20 89 64 85 50 158 16 26 100 16 13 96 1 38 Adult ICU Newborn Adult ED Peds ED All Peds Adult IP Peds IP Reporting Period: 11/1/2014 to 11/30/2014 All ADAMO, ELENA BRADSHAW, SAMUEL L COOK, JAYCE G GRUNZ, RYAN HAIRFORD, AMBER M HESS, BRYAN R HONIG, ERIN J HUNTER, STEPHEN O JOYNER, JAMES KARAMALEGOS, ALEXANDER KUNEFF, RENEE A LOSQ, STEPHANIE E MARSH, MELANIE MCINTYRE, BRITTANY J MERRELL, DAVID J NETTEY, RALPH PILOTO DE LA PAZ, DAYARMYS RIGBY, MICHAEL D SCHMITZ, JEREMY E SONNENBERG, ERIC G STREET, CHRISTOPHER M THEKKEKANDAM, MARIA T WIGHT, ANDREW WILLIAMSON, EDWARD V 0 0 0 0 0 4 0 0 0 2 0 0 0 0 0 0 0 6 1 0 2 0 0 3 0 7 0 0 1 1 0 0 0 0 5 7 54 17 93 49 86 6 17 168 0 12 87 64 81 49 156 12 24 2 14 10 96 1 35 157 0 0 2 1 2 1 9 0 1 2 1 4 0 6 1 2 0 0 1 1 0 1 14 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 1 0 0 0 0 0 14 1 1 0 0 0 0 5 121 2 1 0 2 1 2 1 2 36 2 0 0 0 2 83 0 1 1 0 0 1 1 3 0 2 0 1 0 0 0 86 0 0 120 1 1 0 2 1 2 1 2 35 2 0 0 0 2 62 0 3 0 0 1

Patient and Visit Volume Report by Level of Service Moses Cone Family Medicine Center 11/1/2014 11/20/2014 Patient Count Visit Count ADAMO, ELENA 43 43 23658 PR OFFICE OUTPATIENT VISIT 10 MINUTES 1 1 23660 PR OFFICE OUTPATIENT VISIT 15 MINUTES 41 41 23662 PR OFFICE OUTPATIENT VISIT 25 MINUTES 1 1 Patient Count Visit Count BRADSHAW, SAMUEL L 35 240 PR SUBSEQUENT PRENATAL CARE 2 2 242 PR POSTPARTUM CARE VISIT 2 2 23648 PR OFFICE OUTPATIENT NEW 20 MINUTES 1 1 23660 PR OFFICE OUTPATIENT VISIT 15 MINUTES 27 27 23662 PR OFFICE OUTPATIENT VISIT 25 MINUTES 1 1 23860 PR PREVENTIVE VISIT,EST, INFANT < 1 YR 3 3 36

Cheryls Way

Visits/Encounters Rivas-Orozco Manivannan Sitafalwalla Grenwood Stringam Richards Johnson Jamison Madani Novales Pascual Cooper Sciarra Pechon Ahmed Jensen Ballew Bajwa Lester Cooke Gelou Bahia Daji Clinic 1302147914061398139216871598649668610577654735605652 105102105103125178156 77 Pt > 60* 255 288 326 383 324 366 383145160176140160172140197 24 28 14 28 29 32 38 22 Pt < 10* 67 58 51 50 41 67 69 39 39 21 26 47 49 17 32 Adult Inpt 10 302 376 251 21 68105 70329 53340194457429185216255191580443 7 9 6 2 7 4 7 5 ICU Inpt Peds Peds ER 45 18 54 17 36 46 19 1 12 20 9 33 24 30 53 1 5 5 14 11 11 23 128 1 2 2 64 13 93106 131 10 18 102 61 2 4 NB 11 17 40 50 47 19 54 3 22 27 9 35 20 5 15 13 15 7 5 19 10

Dear Resident, FYI, below are your patient visit statistics as of December 31, 2014. The top number is the total number of clinic patients you have seen since the beginning of residency. The three numbers below are percentages that show you where you stand in comparison to the number of visits you need to graduate and to your peers. Remember that a total of 1975 visits are required to graduate. These numbers reflect the "official" count per Jennifer Powell, Business Office Manager, and are based on office visits and charges. No other counting of visits will be used or acknowledged. Also included below are the number of the required patient encounters you have documented. Remember that regardless of your training level, all residents are required to document these encounters. In this graphic, the numbers show the required number, the number of encounters you have documented and the average number of encounters logged by your class. Encounter numbers as a whole are reported to the ACGME as a measure of resident progress and program quality. For this reason, you are required to document all encounters, even after you have achieved the requisite individual requirement. Let me know if you have any questions. Cheryl

Visits/ Encounters Clinic Percentage Pechon 125 5 6 5 Class Average Your Average Expected Average Adult Inpt ICU Newborn Peds Inpt 750 15 40 75 255 14 345 10 12 81 7 93 Your Count Required Average Class

Annettes Way

What do we do with the data once the beans have been counted?

ACGME Web Ads Annual entry of encounter numbers for each resident

Residency Performance Index Resident outpatient experience-On the survey, you may answer these 4 questions for up to 5 separate FMC sites. Describe your FMCs Certification Level (1,2,3) Average # of patient visits in the FMC for your graduating residents over the last 3yrs % of pts over the age of 60 seen by your residents in the FMC % of pts under the age of 10 seen by your residents in the FMC

Residency Performance Index Resident inpatient and ER experience Average # of personally managed adult medicine inpatients for your residents during their 3 year residency Average # of personally managed ICU pts for your residents during their 3 year residency Average # of personally managed pediatric ER pts for your residents during their 3 year residency Average # of personally managed pediatric inpatients for your residents during their 3 year residency

Thank you! Cheryl.Haynes@sr-ahec.org Darcy.Hitz@conehealth.com asheets@susquehannahealth.org