1. The PCMH Experience: Developing the Optimal Orientation Process Lance Fuchs, MD FAAFP Jodi Berzak-Wolf, DO Kaiser Permanente San Diego Family Medicine Residency STFM Presentation 2016

2. Introduction We will share how we integrated our first block rotation with our orientation process We will share some thoughts about the ideal “onboarding” process We will discuss your interests and questions

3. Get Acquainted Who are you? Where are you from? What is your role? What is one thing that you hope to learn or discuss during this session?

4. Our Residency 6 residents per year Community-based HMO Our Family Medicine Center is the medical home for over 45,000 patients Level 3 PCMH “essentially” unopposed

6. What are the goals of the onboarding process? Prepare the resident to start their job and succeed Optimize resident satisfaction and engagement Familiarize the resident with organization or company culture Teach them the program’s values, vision and mission Make the resident feel connected with the other residents and with the rest of the team Identify unique challenges or needs early

7. Making A Positive First Impression Be well prepared before they arrive Map out a schedule Minimize time reviewing policies and paperwork Be accessible Be enthusiastic and encouraging – you set the tone

8. Resident-Centered Orientation Make an extra effort to ensure that they feel comfortable at the beginning Elicit their unique interests, skills and goals at the beginning (Time Capsule: What will your legacy be after you graduate?)

9. What do you want to teach them about your culture? Culture of Excellence Culture of Feedback You are adult learners. You are professionals. Medicine is not a 9 to 5 job. Learn work-life balance now.

10. The Challenge of Not Enough Time Communicate with the new residents that this a complex system so you are not going to learn everything you need to know during orientation. Clarify your expectations: “I hope that after the first 5 weeks with us, you feel like you are part of our team, that you have a better understanding of our Family Medicine Center and our community and that you feel relatively comfortable navigating a clinic half day.”

11. What makes our experience unique? All six residents are in clinic together for their first 4 week block after one week orientation Regional orientation Taught PCMH concepts and our processes for achieving PCMH goals Community-oriented experiences

12. What makes our experience unique? OSCE’s Direct Observations one per day Didactics twice a day on “the basics” Sharing pearls at the end of each half day Hospital Orientation

13. Community-Oriented Experiences Work in Community Health Center Teach Summer Urban Fellowship students Summer Urban Fellowship Health Fair Community Sports Physicals Medical team for the World Games of the Special Olympics Boys and Girls Club Summer Games

15. Social Activities New residents are invited to our residency graduation Bonfire at the beach Two road trips to LA together

17. PCMH Model Basic Concepts of PCMH Model Our Processes of Achieving Level 3 PCMH The Triple Aim (better care, better health, lower cost)

18. Specifics that we will share Monthly schedule Feedback forms PCMH presentations How we use Evernote as a reference for calendars, articles, presentations and cheat sheets

19. References The Joint Principles of the Patient-Centered Medical Home http://www.aafp.org/dam/AAFP/documents/practice_management/pcmh/initiatives/PCMHJoint.pdf The 10 Building Blocks of High-Performing Primary Care Thomas BodenheimerThomas Bodenheimer, MD, Amireh Ghorob, MPH, Rachel Willard-Grace, MPH and Kevin Grumbach, MDAmireh GhorobRachel Willard-GraceKevin Grumbach Annals of Family Medicine. March/April 2014. 12(2): 166-171. The Future is Here: PCMH Implementation Strategies Timothy Munzing, MD, Lance Brunner MD. Fmdrl.org: 4/17/2012.