Creating patient-centered models of primary care is a priority at UT Medicine San Antonio and the Health Science Center. Providing a medical home for patients is the recommended national model of care, as well as a major focus of healthcare reimbursement and policy reform.
Providing a medical home means that UT needs to improve access to care at the clinic. However, there can be many challenges and variables in scheduling residents and interns in the clinic. Some of the challenges revolve around how often residents and interns can be in the clinic since they must be scheduled for many different types of clinical experiences and responsibilities and then it may be difficult to determine how many patients they can see in a day.
Another concern is about the guidelines and expectations set for each type of residency program set nationally by the Accrediting Council for Graduate Medical Education. According to Luci Leykum M.D. of UTHSC San Antonio and lead researcher for several grants, “We have to adjust the schedule when residents have a scheduling conflict and we need to find someone else to work in their place. We also have to maintain a certain ratio of supervising faculty members to the residents.”
To work on challenges that are part of the complicated scheduling process in clinics and hospitals, UT Health Science Center in San Antonio awarded two grants for $560,000 to improve the quality of patient care. One grant for $280,000 will optimize the scheduling process for medical interns and resident in two primary care clinics where UT Medicine San Antonio provides care and clinical training.
The second grant also for $280,000 is designed to better organize and streamline hospital processes for patients who need surgery. Realizing that preparing a patient for surgery and post-operative care often involves coordination among several different kinds of physicians as well as nursing care and other services, a process needs to be developed to create individualized patient plans. This is important so that each patient will receive the right pre-operative imaging and tests, fill out the appropriate paperwork, see their specialists in the right order, and coordinate care and information among all providers.
The primary end goal is to build systems engineering tools to improve processes needed in specific areas, such as in two primary care clinics and the surgery department of the University Hospital. The tools will then be made available to other clinics within UT Medicine San Antonio and the Health Science Center community and to corresponding departments at other institutions within the UT System.