1. Family Medicine “D” Service: Built to Deliver In Every Way
Jessie Flynn, MD; Valerie King, MD, MPH; Scott Fields, MD
Department of Family Medicine, Oregon Health & Science University
Goals
Curriculum Structure
Outcomes 2006
Ensure patient safety and high quality care
Continuous educational improvement
Built on prior successes
Maximize maternity care continuity
Robust and supportive maternity care curriculum
4 week block rotations
3 months on “D” Service during residency
1 month in PGY-1 year
2 months in PGY-2 year
Service rounds and L&D coverage
Dedicated “Nightfloat” for L&D
388 vaginal deliveries
97 Cesarean deliveries
Average PGY-3 deliveries: 60
7/12 grads do maternity care
2/12 grads have C/S privileges
Resident Views
Whom do we serve?
“Excellent experience in basic prenatal care”
“Excellent to work with our own faculty doing obstetrics”
“D service is excellent, lots of learning not covered in OB or Peds”
4 Family Health Centers
1 FQHC, 1 RHC, 2 OHSU community clinics
1 County health department clinic
800 admissions per year 2006
Increased from 480 in 2005
Educational Environment
Resident & faculty pairs for continuity prenatal care
Senior residents learn supervisory role at births
Students participate in continuity PNC
Structured weekly didactics
Operative delivery training option for PGY-3s
NICU admitting privileges
ALSO and NRP training
Collegial and constructive outside relationships
Future Directions
Challenges
Formal training in OB US
Group prenatal care
Improved patient tracking and QI with electronic health record
Expanded reproductive health curriculum
Urban University tertiary care hospital
Continuity of care for women and residents
Learning environment for residents and faculty