Although physicians in family medicine, internal medicine and pediatrics all work in primary care, they do not always work in tandem. One grant program is trying to change that by breaking down barriers between the three specialties.
For the next three years nine institutional faculty teams will participate in a project called Professionals Accelerating Clinical and Educational Redesign (PACER),(pcpacer.org) which supports transformation initiatives leading to more collaborative care.
PACER is dedicated to teaching faculty members in primary care residencies and other health professions to work in teams with their peers and continue to teach trainees the value of team-based care. Each team enters the program with its own project goal.
For instance, one participating school plans to develop a unified population management plan. Another team proposes to create a faculty development curriculum that will train learners in patient-centered medical home principles, quality improvement and population health. A third school will send a team of learners from multiple disciplines to a federally qualified health center where they will work in a collaborative setting.
- For the next three years nine institutional faculty teams will participate in a project called Professionals Accelerating Clinical and Educational Redesign, (PACER) which supports transformation initiatives leading to more collaborative care.
- PACER expands on a successful pilot program by bringing together an inter-professional team of faculty members.
- By learning to collaborate consistently, primary care specialties could speak with one voice about needs that often do not receive adequate support.
"We want to help break down the traditional silos between disciplines in academic institutions," said Patrice Eiff, M.D., PACER project director and professor of family medicine at Oregon Health & Science University. "These teams have the opportunity to create a shared primary care vision that supports a model of care that meets the needs of our patients, families and communities."
PACER expands on a successful pilot program by bringing together an inter-professional team of faculty including physicians, physician assistants, nurses, pharmacists and behavioral health specialists. Each team earned its slot in a competitive application process.
"Our vision is that PACER will help family medicine, internal medicine and pediatric residencies transform their continuity clinic sites into inter-professional collaborative practices and foster more collaboration among all primary care health professionals," Eiff said.
Each of the nine participating institutions is sending a 10-person team with at least two faculty members from family medicine, two from internal medicine and two from pediatrics, as well as faculty members from other health professions. The teams will have their first face-to-face training in Denver on April 4-5, 2016.
"Working together as a unified primary care force can help strengthen family medicine residencies within their sponsoring institutions," Eiff said.
Although the overall project is not tracking patient outcomes, the teams will focus on improving the quality of care in their own redesign of practices and training programs. Faculty will work on getting residents into their practices on a more regular basis instead of only when their schedule allows, which is typical in a hospital-focused training model.
The project began in the summer and continues until June 2018. Planners want the concept to continue beyond the funding period by building regional centers that will offer professional development for other primary care training programs.
Those regional centers are expected to be built in PACER's second and third year to allow residencies that were not part of the grant program to participate. They are intended to host annual conferences, provide faculty development training, share resources and foster collaboration among primary care training programs. Locations for the regional centers are still being identified but Advocate Lutheran General in suburban Chicago is slated to host the first site.
As another step to ensure sustainability, the teams will select 18 additional primary care residencies to work with on transformation projects. An added potential benefit is that by creating better inter-professional collaborative practices in primary care, the new model could be a recruiting tool for future medical students.
"If PACER is successful in catalyzing their work to create a high-functioning clinical training environment, then it will be attractive to students who want to practice in that model of care," Eiff said.
By learning to collaborate consistently, the three primary care specialties could approach their hospital system leaders and speak with one voice about needs that often do not receive adequate support, Eiff said. Or they could approach their electronic health record vendor as a unified group, given that most primary care practices seek the same type of data from patient reports.
A pilot project, the Primary Care Faculty Development Initiative that ended in 2014, was composed of four institutional teams and included primary care residency faculty but not other training programs for health professionals.
PACER is funded by the American Board of Family Medicine, American Board of Internal Medicine, American Board of Pediatrics, Accreditation Council for Graduate Medical Education and the Josiah Macy Jr. Foundation.
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