Building Two Different Models

Because Summa Health Systems has separate curricula for its internal medicine and family practice residents, each program developed different approaches for delivering diabetes care. The main distinction between the internal medicine and family practice models involves the length of time residents have to devote to ambulatory care practice.

Summa: Building Two Different Models

The main distinction between the internal medicine and family practice models involves the length of time residents have to devote to ambulatory care practice.

• For the internal medicine residents, who primarily follow an inpatient residency model with an emphasis on transitioning care to the continuity clinic, learning how to deliver care using the Chronic Care Model must be accomplished during a 1-month per year ambulatory block rotation for categorical and preliminary residents.
• The family medicine postgraduate year two residents have 2 half-days per week and postgraduate year three residents have 3 to 5 half-days per week for 1 year to assimilate this knowledge and gain experience with the model.

These differing program requirements were the driving factors for model development.

In both models, residents learn to work within the interdisciplinary team framework of the Chronic Care Model. However, residents in family medicine take a more active role in driving the entire care team process with nurses serving as coleaders.

In the internal medicine process, nurse practitioners take ownership of the planned-visit process, while residents focus more on facilitating the general team approach and learning when and how to intensify particular aspects of care.

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