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Flower Longitudinal Ambulatory Experience
Mother, baby, and resident The continuity program provides a special experience for residents to foster the physical, intellectual and emotional growth of children, as well as to observe and manage the course of certain diseases and therapies over an extended period of time. Residents can choose from various clinics throughout the city of Boston that each serve a different cultural and socio-economic population. Each resident carries a panel of patients specially designed to ensure broad exposure to multiple-age groups and diverse medical problems.

Continuity sites are available in both hospital and community settings. In addition to typical primary care clinic experiences, there are a number of other clinic opportunities including an International Health Clinic at Boston Medical Center, primarily Spanish speaking clinics at Martha Elliot Health Center and East Boston Health Care Center, a young parent continuity clinic at Boston Medical Center and Children's Hospital, as well as several other multi-cultural, community-based health clinics.

Residents in the Categorical track devote one afternoon each week throughout the three years to their continuity practice. Residents are relieved of other clinical responsibilities during their scheduled continuity clinic time. Residents' clinics are rescheduled for an alternate day when the resident is post-call for their regular clinic day

In the first year, Urban Health and Advocacy track (UHAT) residents spend one-half day each week in their continuity sites. Beginning with the PL-2 year, UHAT residents select an additional half-day experience to augment their training. They have the option of choosing a second continuity clinic (residents have sometimes used this to obtain outpatient experience in specialty practices like GI or adolescent clinics) or may select a project in urban health, advocacy, global health or public policy. In selecting a project, the UHAT resident is coupled with a faculty mentor throughout the PL-2 and PL-3 years.

Children’s Hospital Primary Care Center
Children's Hospital Primary Care Center (CHPCC) and Martha Eliot Health Center (MEHC) are two of the continuity sites available to residents. Both are engaged in a patient-centered primary care redesign effort through the Academic Innovations Collaborative (AIC), established by the Harvard Medical School Center for Primary Care. The AIC was created to foster rapid transformations in care delivery and education within Harvard-affiliated primary care teaching practices and BCRP residents are active participants.

CHPCC and MEHC's redesign is focused on four major transformation areas: multidisciplinary patient care teams, population management, complex disease management, and patient empowerment. Some of the major changes to be rolled out over the two years of the collaborative include the creation of primary care teams, development and use of patient registries to facilitate population and complex care management, and the implementation of new technology, including clinical decision support and discharge and care plan summaries.

A chief goal of the AIC is to involve our residents in redesign activities. The resident education curriculum will be rewritten to include topics related to team-based care delivery and population management; residents are integrated into the care teams, attending team huddles and included in team communication regarding patient issues; and residents' input is solicited through surveys and informal feedback sessions.

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