CITE Project: University of Louisville Family Medicine Residency Program, 2000-03

Partnerships for Quality Education

Field of Work: Aligning the training of physicians and nurse practitioners with the demands of 21st-century clinical practice.

Problem Synopsis: In the 1990s, managed care became one of the dominant forces in health care. Physicians and nurse practitioners (NP's) were expected to know how to manage patients' health, often within a fixed budget. Although care was increasingly taking place in outpatient settings, physicians continued to receive most of their training in hospitals rather than in ambulatory care centers. They also received little training in preventive care, or in interprofessional collaboration.

Faculty at the University of Louisville sought to improve the care of Medicaid managed care patients.

Synopsis of the Work: Partnerships for Quality Education (PQE) (April 1999 through January 2009), was initially funded by the Pew Charitable Trusts (during which time it focused on physicians only) and then by RWJF (which expanded it to include NP's). The program sought to improve a core set of skills in physicians and nurse practitioners, including interprofessional collaboration, chronic illness management, systems-based care and practice-based quality.

The University of Louisville participated in the Collaborative Interprofessional Team Education component of PQE (CITE). Its CITE project brought together three schools at the University of Louisville—the School of Family and Community Medicine, the School of Nursing and the Kent School of Social Work/Marriage & Family Therapy—with a Medicaid managed care company, Passport Health Plan (PHP) of Louisville, Ky.

Lessons Learned: Project Director Karen Newton offered the following practical lessons:

  • For teamwork to be practiced effectively, it must take place in a situation in which learners view it as desirable.
  • Team members need to be trained in how to hand off patients from the doctor to other team members.
  • Primary care offices should shift their culture regarding chronic illnesses from physician-centered care to one promoting team care; they should "brag" that this care is available.

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