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Changes in 2008-2009 |
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Starting this year, the BCRP is renovating the inpatient ward team structure at Children's Hospital Boston with a geographic team structure, expanding and enhancing the subspecialty rotations, and providing for planning time in the Junior Year to prepare for an enhanced Career Development Block in the Senior Year.
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The leadership, faculty, and residents of the BCRP created a new team structure for July 2008 on the inpatient wards of Children's Hospital Boston - the geographic system of inpatient ward teams. Over the past several decades, inpatient resident teams had evolved to single or multiple specialty-based teams often on several different units and floors of the hospital. This structure impacted efficiency, communication, and teamwork.
In order to improve patient care, optimize communication, and enhance efficiency of team function, the BCRP is creating three geographic (unit-based) ward teams on 9 South, 9 East, and 7 West and one Float Team for medical patients admitted to other medical units. Patients of subspecialty services will be preferentially admitted to specific units that offer special nursing expertise. The outcomes that we hope to achieve in the new geographic system are:
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- More time for patient interactions and teaching at bedside
- Family-centered rounds
- Better care coordination and communication with nursing staff
- Continued focused subspecialty education for our housestaff
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We believe this new model will provide the proper environment for training in order to fulfill our vision of producing the comprehensive pediatrician of the future with in-depth training in the pediatric subspecialties and experience in the breadth of hospital-based care.
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The BCRP has expanded the number of subspecialty rotation options and enhanced the rotations to better reflect the breadth of subspecialties by including outpatient clinical experiences and diagnostic and consultative services, with an emphasis on the common problems referred to pediatric subspecialists from general pediatricians. The wide range of subspecialty opportunities at CHB and BMC will compliment the exposure on the inpatient services at both institutions.
In the PL1 year trainees are exposed to Allergy/Immunology, Cardiology, Emergency Medicine, Endocrinology, Neurology, and Rheumatology. In the PL2 year, trainees are exposed to Bone Marrow Transplant, Hematology, Infectious Diseases, Oncology, and Pulmonary Medicine. In the PL3 year, residents are given the opportunity to sample from a variety of subspecialty rotations including Genetics, Dermatology, Neurology, and Endocrinology.
This enhancement of subspecialty rotations will provide a broad and deep exposure to subspecialty pediatrics and assist our trainees in selecting a career path.
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A new 2-week rotation in the PL2 year provides residents with the opportunity to work with a mentor to plan for the 3-month CDB rotation in the senior year. Residents will utilize this time to design a research project, submit the project of review by the Institutional Review Board, and select a laboratory and a mentor. Thus, senior residents will be further along in the planning process to ensure optimal productivity during their 3-month CDB Block.
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This year, we have created an intensive orientation process with the specific intention of better preparing interns for the first day of internship. Besides the traditional information sessions, we have developed simulations to enhance the function of interns in their inpatient rotations, and provided modules and clear guidelines about written documentation, oral presentations, procedures, sign-out, and on-call expectations. We also orient new interns to the information systems and have them gain competence in order-writing, viewing medical information, laboratory results, and images.
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There are two residency-wide retreats held in the fall and late winter in which we address a variety of topics that are part of the basic culture or values of the residency program. In the past, we addressed themes such as teaching, leadership, feedback, work-life balance, patient-centered care, communication skills, and skills training. It is an opportunity for all residents to spend a day together to reflect on the topics and have a welcome break from the day-to-day grind of residency. In the late spring, we host class-wide orientation for Rising Juniors and Rising Seniors, in which we focus on new aspects of the curriculum, leadership skills, and personal development.
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