Challenges to improving chronic disease care and training in residencies.

摘要: PURPOSE To improve quality of care for chronic disease, professional organizations and medical providers are adopting new models. The transition to better delivery systems is not easy there many barriers under the best circumstances. This study investigated residency-based experiences with changes in teaching disease care. METHOD In 2004-05 at University Southern California, authors conducted qualitative cross-sectional in-depth interviews directors grant-funded projects. Open- closed-ended questions explored intent challenges encountered by primary residencies implementing improvements training. RESULTS Six out 14 program director responded, reporting that rotation-based longitudinal were used teach deliver improved Common identified across residency sites, as well unique particular settings. Among these engaging faculty residents who spend limited time practice center, institutional related authority, competing priorities, process, resources. CONCLUSIONS Successful innovations training possible residencies, but their implementation cannot be taken lightly. There predictable can dealt locally, also others would benefit from coordinated national attention.