, Volume 28, Issue 12, p 1556
Date: 10 Sep 2013

An Evaluation of Continuity Clinic Redesign

This is an excerpt from the content

To the Editor: We read with great interest the article by Wieland and colleagues regarding the redesign of their residency program to a 50/50 alternating ambulatory–inpatient schedule.1 Interestingly, patient continuity decreased from both a provider and patient perspective, and there was no change in resident or faculty satisfaction with the clinic restructuring.

We implemented a similar system in the last academic year (AY 2012–2013). We intended to add a stronger emphasis on ambulatory care. We were also addressing what we felt was a common problem in the traditional model of residency—that staffing residents to cover inpatient needs with restricted duty hours occurred at the expense of canceling or changing continuity clinic days. This led to a steady increase in patient cancellations and rescheduling.

Based on survey and clinic data, our experience with the transition to a 50/50 block schedule mostly mirrors the experience described by Wieland et al. Our residents did note an overal