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Establishing a Medical Home

In 2005, NH Dartmouth Family Medicine Residency received a three-year federal training grant from the U.S. Health Resources and Services Administration. The grant, which totals nearly $500,000, establishes new curricula to integrate the Medical Home Model into the residency’s existing model of care. The project provides residents with skills and tools necessary for practicing in the Medical Home Model. Additionally, it offers an integrated, longitudinal interdisciplinary team experience in medical home care for high-risk populations. Drs. Skip DeVito and Dan Eubank oversee the project.

Beyond the Medical Home

NH Dartmouth Family Medicine Residency is participating in a Center for Medical Home Improvement grant to pilot and implement medical home quality improvement initiatives at Capital Region Family Health Center, the residency’s practice site for training family physicians, and its satellite Hillsboro-Deering Family Health. Drs. Skip DeVito and Doug Dreffer oversee the project.

Hyperbilirubinemia Management Improvement

NH Dartmouth Family Medicine Residency is implementing new guidelines for managing neonatal hyperbilirubinemia at Concord Hospital. While JCAHO has mandated changes in the management of neonatal, the residency’s goals include:

  • Implementing a system that is based in evidence wherever possible.
  • Creating uniformity of management throughout the Concord Hospital community.
  • Evaluating the direct and indirect outcomes of the change.

Additionally, through a partnership with Concord Regional Visiting Nurse Association, the residency provides standardized evaluation and care planning for infants following discharge from Concord Hospital.

Oral Health Medical-Dental Collaborative

The Capital Region Family Health Center received a grant from the Endowment for Health to promote oral health screening and education to residents, faculty and patients. A team including a dental hygienist, dentist, faculty pediatrician and community health specialist have been successful in implementing education on early childhood caries. The education, performed in the context of well-child visits, includes screening and application of fluoride varnish to children ages 0-3 years. As a result of the project, residents, faculty providers and patients have shown an increased knowledge in oral health screening. In the final year of the grant-funded project, oral health screening and education will be extended to pregnant women. Dr. Suzanne Boulter oversees the grant.

Group Visits for Diabetes Patients

At NH Dartmouth Family Medicine Residency quality improvement is not only an ACGME competency, it’s an active, ongoing participatory process. One NHDFMR class conducted a yearlong project on improving diabetic care for their patients. By applying QI principles the residents achieved statistically significant improvements in diabetic care including: immunization rates, foot exams, measurement of micro albumin, and other important parameters of care.

Additionally, they provided collaborative diabetic group visits for their patients. The innovative group visits were so successful they were incorporated into the residency’s learning curriculum. The residency also offered group visits for nursing home visits, heart disease and depression. A review of the experience, including an interactive poster session, was presented at the 32nd NAPCRG Group Visits for Diabetes Patients

Pioneering Group Visits

At NH Dartmouth Family Medicine Residency quality improvement is not only an ACGME competency, it’s an active, ongoing participatory process. One NHDFMR class conducted a yearlong project on improving diabetic care for their patients. By applying QI principles the residents achieved statistically significant improvements in diabetic care including: immunization rates, foot exams, measurement of micro albumin, and other important parameters of care. Additionally, they provided collaborative diabetic group visits for their patients. The innovative group visits were so successful they were incorporated into the residency’s learning curriculum. The residency also offered group visits for nursing home visits, heart disease and depression. A review of the experience, including an interactive poster session, was presented at the 32nd NAPCRG annual meeting.