A Novel Financial Incentive Program for Residents to Improve Communication with Primary Care Physicians

1University of California San Francisco, San Francisco, CA
2University of California San Francisco, San Francisco. CA
3University of California San Francisco, San Francisco, CA
4UCSF Medical Center, San Francisco, CA
5University of California San Francisco, San Francisco, CA
6University of California San Francisco, San Francisco, CA

Meeting: Hospital Medicine 2010, April 8-11, Washington, D.C.

Abstract number: 171

Background:

Financial incentive programs have been successfully used lo encourage performance improvement, but until now. few such programs have engaged physicians‐in‐training. UCSF Medical Center and Office of Graduate Medical Education implemented a novel group financial incentive program for residents in 2007, whereby residents receive bonuses by achieving specific quality goals. This program provides a unique opportunity tc link the quality improvement objective of the medical center with training residents in important core competencies,

Purpose:

Beginning in September 2009, internal medicine residents at UCSF were incentivized to communicate with inpatients' primary care providers (PCPs). We developed this incentive recognizing the importance of communication between inpatient and outpatient providers in ensuring safe care transitions, and recognizing this communication as a key component of the core competencies of systems‐based practice, professionalism, and communication.

Description:

The incentive program lor PCP contact was initiated by residents and is resident run. We created a multifaceted quality improvement program that uses education, audit and feedback, and public reporting of data in addition to the financial incentive to promote the importance of PCP communication. PCP contact is measured by the presence of a templated note in The electronic medical record that was developed specifically for this purpose. These data are reported as the proportion of discharges for whom PCP contact was documented, stratified by each medical ward team; data are fed back weekly to residents via email and public display in the resident work room. Residents also receive didactic and small‐group education about PCP communication. Based on a survey during Ihe 2008‐2009 academic year revealing that residents contacted about 66% of patients' PCPs, the goal for PCP contact was set at 80% of discharges. The financial reward is $300 per resident per year.

Conclusions:

During the first week of the incentive program, medicine resident ward teams contacted the PCPs of 61% of inpatients. The proportion steadily improved each week — within 4 weeks, the target of 80% contact had been met, and improvement has been sustained. The program is being used as a vehicle for teaching residents about quality improvement and important care transitions principles. This program represents a unique, resident‐driven collaboration between the medical center and the residency program and provides a template for involving residents in quality improvement activities. Future directions include determining the effect of the program on PCP satisfaction with communication and using this program lo provide feedback to residents on the quality of care transitions.

Author Disclosure:

L. Kalanithi, none; C, Coffey, none; A. Vidyarthi, none; A. Green, none; R, Baron, none; S, Ranji, none.

To cite this abstract:

Kalanithi L, Coffey C, Vidyarthi A, Green A, Baron R, Ranji S. A Novel Financial Incentive Program for Residents to Improve Communication with Primary Care Physicians. Abstract published at Hospital Medicine 2010, April 8-11, Washington, D.C. Abstract 171. Journal of Hospital Medicine. 2010; 5 (suppl 1). https://www.shmabstracts.com/abstract/a-novel-financial-incentive-program-for-residents-to-improve-communication-with-primary-care-physicians/. Accessed November 17, 2019.

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