Building the Case for Implementing Postgraduate Residency Training Program
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Community Health Center, Inc. is proposing to implement postgraduate residency programs for nurse practitioners and clinical psychologists. Residencies would provide intensive clinical training over 12 months to address workforce shortages and reduce burnout. Core elements include precepted clinics, specialty rotations, didactics, and quality improvement training. Residencies aim to develop expert clinicians prepared to lead community health centers. While start-up costs are required, residencies may increase retention, productivity, and recruitment over time, providing a return on investment. Residencies can smooth new providers' transition to independent practice.
Building the Case for Implementing Postgraduate Residency Training Program
- 1. Building the Case for Implementing Postgraduate Residency Training Program December 2nd, 2019
- 2. Disclosure • With respect to the following presentation, there has been no relevant (direct or indirect) financial relationship between the party listed above (or spouse/partner) and any for-profit company in the past 12 months which would be considered a conflict of interest. • The views expressed in this presentation are those of the presenters and may not reflect official policy of Community Health Center, Inc. and its Weitzman Institute. • We are obligated to disclose any products which are off-label, unlabeled, experimental, and/or under investigation (not FDA approved) and any limitations on the information hat we present, such as data that are preliminary or that represent ongoing research, interim analyses, and/or unsupported opinion.
- 3. Get the Most Out of Your Zoom Experience • Use the Q&A Button to submit questions! • Recording and slides are available after the presentation on our website within one week • View past webinars at www.chc1.com/nca
- 4. CHCI Profile: Founding year: 1972 Primary care hubs: 16; 204 sites Staff: 1,000 Patients/year: 100,000 Visits/year: 550,000 Specialties: onsite psychiatry, podiatry, chiropractic Specialty access by eConsult to 41 specialties Elements of Model: Fully integrated teams and data Integration of key populations Data driven performance “Wherever You Are” approach Weitzman Institute: Formal Research Quality Improvement Practice Redesign Implementation Science Clinical Workforce Development Locations and Service Sites in Connecticut Community Health Center, Inc. (CHCI)
- 5. National Cooperative Agreement Clinical Workforce Development Provides free training and technical assistance to health centers across the nation through national webinars, learning collaboratives, activity sessions, trainings, research, publications, etc. ©Community Health Center, Inc.
- 6. Objectives • Identify the drivers of implementing postgraduate nurse practitioner and clinical psychology residencies at your health center • Describe the process of implementing postgraduate residency programs • Recognize the benefits of implementing postgraduate residency programs
- 7. Growth and Development of Postgraduate Residency Training Programs
- 8. Polling Question Are you familiar with postgraduate nurse practitioner residency programs?
- 9. Why Start a Postgraduate Residency Program? Solve a Problem • Address the shortage of expert clinicians, particularly for vulnerable populations • Give new primary care medical and behavioral health providers the opportunity for postgraduate residency training in fully integrated primary care settings • Support the development of confidence, competence and mastery in the FQHC setting • Reduce attrition due to burnout and distress during the initial postgraduate year • Provide the depth, breadth, volume, and intensity of clinical training to a model of care consistent with PCMH, IOM/FON, and FQHC principles and services • Prepare the next generation of leadership for FQHCs For the common good For the good of clinicians For the good of your organization
- 10. A Framework for Postgraduate Residency Programs • 12 months, full time employment • Full integration into all aspects of the organization • Continuous training to clinical complexity and a high performance model of care – Team-based inter- professional collaboration – Data driven quality improvement – Expert use of technology Clinical-based practice experiences Regularly scheduled education session System based learning and Quality Improvement Population health focus Leadership and professional development
- 11. Core Elements of a Postgraduate NP Residency 1) Precepted Continuity Clinics; residents develop and manage their own panel of patients with the exclusive attention of an expert preceptor NP, physician, or PA; primarily new patients 2) Specialty Rotations; Experience in orthopedics, dermatology, women’s health, adult and child psychiatry, geriatrics, pediatrics, newborn nursery, HIV/Hep C care, and healthcare for the homeless 3) Mentored Clinics; Focused on diversity of chief complaints, efficiency, episodic and acute care working within a primary care team 4) Didactic Sessions; High volume/complexity/risk/burden topics. Includes participation in Project ECHO sessions for managing chronic pain, treating HIV, Hepatitis C, and opioid addiction 5) Quality Improvement Training; Training to a high performance QI model, including front line QI improvement, data driven QI, and leadership development.
- 12. Psychiatric Nurse Practitioner Residency Program 1. Precepted Continuity Clinics; residents develop their own patient panel of adults and children, working with dedicated support of an expert preceptor (PMHNP or Psychiatrist) 2. Specialty Rotations; Rotations, of varied length, in several mental health specialty areas including, but not limited to, medication assisted treatment, group therapy, ED crisis intervention, intensive outpatient program, LGBTQ+, and interventional treatments (ECT, TMS, acupuncture). 3. Shared Learning Sessions; Focused on special populations with high risk, complexity, and burden, most commonly effected through the Project ECHO platform. Areas include chronic pain, HIV, HCV, SUD, LGBTQ, and pediatrics. 4. Supervision; Weekly individual and groups sessions focused on clinical and professional development of new providers 5. Quality Improvement Training; Training to a high performance QI model, including front line QI improvement, data driven QI, and leadership development.
- 13. Polling Question Do you currently have a licensed clinical psychologist on staff at your organization?
- 14. Postdoctoral Clinical Psychology Residency 1. Clinical Practice Experiences; independent clinic sessions in integrated practice settings 2. Supervision; Weekly individual and group supervision sessions designed to meet state specific licensing requirements 3. Site-Specific Clinical Team Meetings; Participate in team meetings to discuss clinical case with the integrated care team 4. Weekly Didactic Sessions; Variety of topics including group therapy, medication management, substance use, child psychology 5. Quality Improvement Training; Training to a high performance QI model, including front line QI improvement, data driven QI, and leadership development.
- 15. Cost Considerations and Sustainability Program investment must be viewed as a multi-year life cycle project Year 1 – Investment Year 2 – ROI Retention of residents Additional benefits • Smooth transition to full time practice already trained to your organization’s system • Increased productivity post residency • Reduce recruitment costs for external candidates • Increased provider satisfaction for staff involved in the program • Creates a network of alumni which can support future recruitment
- 16. Experiences from Previous Residents Garrett Matlick • Class of 2018-2019 • Transition to Practice Nicole Seagriff • Class of 2011-2012 • PCP, Preceptor/Faculty • Leadership Development • Staffing- Clinical Leader
- 17. • Recently implemented program • Successes and challenges • NCA participation
- 18. The Road to Developing a Postgraduate Residency Program • Answer the question: What are your drivers for starting a postgraduate program? • Learn the essential elements of a postgraduate program • Accrediting standards • State licensing requirements • Assess your own resources (physical, human, financial) • Consider creating an academic partnerships • Secure board, leadership, and clinical buy-in • Develop financial and strategic plan including potential partners • Costs and benefits: • Direct and indirect costs • Return on Investment: immediate and longer term • Benefits beyond the financial return
- 19. To download the digital version of "Training the Next Generation: Residency and Fellowship Programs for Nurse Practitioners in Community Health Centers" https://www.weitzmaninstitute.org/NPResidencyBook
- 20. Website: www.npresidency.com www.chc1.com www.weitzmaninstitute.org Margaret Flinter, APRN, PhD, c-FNP, FAAN, FAANP Senior VP and Clinical Director Email: margaret@chc1.com Charise Corsino, MA Program Director, NP Residency Training Email: charise@chc1.com Nicole Seagriff, DNP, APRN, FNP-BC Clinical Program Director Email: Seagrif@chc1.com Chelsea McIntosh Training Director, Postdoctoral Residency Program Email: McIntoc@chc1.com
- 21. Questions!
- 22. Visit our National Learning Library Contact us at nca@chc1.com www.chc1.com/nca