Systems Based Practice

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Residents must demonstrate an awareness of and responsiveness to the larger context and system of health care and the ability to effectively call on system resources to provide care that is of optimal value.

Competency: Understand how their patient care and other professional practices affect other healthcare professionals, the healthcare organizations and the larger society and how these elements affect their practice.

Knowledge/Skills/Attitudes Objectives:

  • Optimize interaction and communication with other health-care professionals, health-care organizations and community resources to promote quality patient care.
  • Participate actively in quality initiatives undertaken by health care organizations.
  • Optimize patient length of stay in acute care facilities by promoting appropriate transition to ancillary levels of care.
  • Promote medication reconciliation across levels and systems of care.
  • Familiarize with the epidemiology of major health issues in the local community.
  • Understand how the local community demographics and socio-cultural beliefs affect health and disease.
Competency: Know how types of medical practice and delivery systems differ from one another, including methods of controlling health care costs and allocating resources.

Knowledge /Skills/Attitudes Objectives:

  • Understand the fundamental differences between the various insurance plans including local PPOs and HMOs, fee-for-service, Medicare, and state Medical Assistance.
  • Recognize the guidelines determining provider and institutional reimbursement including fee-for-service, capitation, hospital DRGs.
  • Document appropriately for different levels of care.
  • Become familiar with various formulary guidelines and pre-certification requirements.
Competency: Practice cost-effective health care and resource allocation that does not compromise quality of care.

Knowledge/Skills/Attitudes Objectives:

  • Recognize resource limitation within the regional and global health care systems.
  • Practice cost-effective medical care by considering cost / benefit analyses in all diagnostic and therapeutic decisions.
  • Identify factors that contribute to rising health care costs and strive to contain costs by optimizing formulary compliance and avoiding unnecessary testing.
  • Practice cost-effective patient care by optimizing length of stay in acute care facilities and promoting transition to sub-acute levels of care appropriately.
Competency: Advocate for quality patient care and assist patients in dealing with system complexities.

Knowledge/Skills/Attitudes Objectives:

  • Minimize perceived conflicts of interest between individual patients and their health care organizations through patient education.
  • Recognize true conflict of interest between individual patients and their health care organizations and always advocate actively on the patient's behalf.
Competency: Partner with health care managers and health care providers to assess, coordinate, and improve health care and know how these activities can affect system performance.

Knowledge /Skills/Attitudes Objectives:

  • Identify and work with other health care professionals and organizations to optimize patient-centered care.
  • Connect patients with established disease management programs offered through their insurances or local institutions.
  • Utilize practice performance data to sharpen population management skills and understand how that improves global system performance.