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Building the Case for Implementing Postgraduate Residency Training Program
1. Building the Case for Implementing Postgraduate
Residency Training Program
December 2nd, 2019
2. Disclosure
• With respect to the following presentation, there has been no relevant
(direct or indirect) financial relationship between the party listed above (or
spouse/partner) and any for-profit company in the past 12 months which
would be considered a conflict of interest.
• The views expressed in this presentation are those of the presenters and
may not reflect official policy of Community Health Center, Inc. and its
Weitzman Institute.
• We are obligated to disclose any products which are off-label, unlabeled,
experimental, and/or under investigation (not FDA approved) and any
limitations on the information hat we present, such as data that are
preliminary or that represent ongoing research, interim analyses, and/or
unsupported opinion.
3. Get the Most Out of Your Zoom Experience
• Use the Q&A Button to submit questions!
• Recording and slides are available after the
presentation on our website within one week
• View past webinars at www.chc1.com/nca
4. CHCI Profile:
Founding year: 1972
Primary care hubs: 16; 204 sites
Staff: 1,000
Patients/year: 100,000
Visits/year: 550,000
Specialties: onsite psychiatry, podiatry,
chiropractic
Specialty access by eConsult to 41 specialties
Elements of Model:
Fully integrated teams and data
Integration of key populations
Data driven performance
“Wherever You Are” approach
Weitzman Institute:
Formal Research
Quality Improvement
Practice Redesign
Implementation Science
Clinical Workforce Development
Locations and Service Sites in Connecticut
Community Health Center, Inc. (CHCI)
6. Objectives
• Identify the drivers of implementing
postgraduate nurse practitioner and clinical
psychology residencies at your health center
• Describe the process of implementing
postgraduate residency programs
• Recognize the benefits of implementing
postgraduate residency programs
9. Why Start a Postgraduate Residency Program?
Solve a Problem
• Address the shortage of expert clinicians, particularly for
vulnerable populations
• Give new primary care medical and behavioral health
providers the opportunity for postgraduate residency
training in fully integrated primary care settings
• Support the development of confidence, competence
and mastery in the FQHC setting
• Reduce attrition due to burnout and distress during the
initial postgraduate year
• Provide the depth, breadth, volume, and intensity of
clinical training to a model of care consistent with
PCMH, IOM/FON, and FQHC principles and services
• Prepare the next generation of leadership for FQHCs
For the
common
good
For the good
of clinicians
For the good
of your
organization
10. A Framework for
Postgraduate Residency Programs
• 12 months, full time
employment
• Full integration into all
aspects of the organization
• Continuous training to clinical
complexity and a high
performance model of care
– Team-based inter-
professional collaboration
– Data driven quality
improvement
– Expert use of technology
Clinical-based
practice
experiences
Regularly
scheduled
education
session
System based
learning and
Quality
Improvement
Population
health focus
Leadership and
professional
development
11. Core Elements of a Postgraduate NP Residency
1) Precepted Continuity Clinics; residents develop and manage their own panel of patients with the
exclusive attention of an expert preceptor NP, physician, or PA; primarily new patients
2) Specialty Rotations; Experience in orthopedics, dermatology, women’s health, adult and child psychiatry,
geriatrics, pediatrics, newborn nursery, HIV/Hep C care, and healthcare for the homeless
3) Mentored Clinics; Focused on diversity of chief complaints, efficiency, episodic and acute care working
within a primary care team
4) Didactic Sessions; High volume/complexity/risk/burden topics. Includes participation in Project ECHO
sessions for managing chronic pain, treating HIV, Hepatitis C, and opioid addiction
5) Quality Improvement Training; Training to a high performance QI model, including front line QI
improvement, data driven QI, and leadership development.
12. Psychiatric Nurse Practitioner Residency Program
1. Precepted Continuity Clinics; residents develop their own patient panel of adults and children,
working with dedicated support of an expert preceptor (PMHNP or Psychiatrist)
2. Specialty Rotations; Rotations, of varied length, in several mental health specialty areas including, but
not limited to, medication assisted treatment, group therapy, ED crisis intervention, intensive
outpatient program, LGBTQ+, and interventional treatments (ECT, TMS, acupuncture).
3. Shared Learning Sessions; Focused on special populations with high risk, complexity, and burden,
most commonly effected through the Project ECHO platform. Areas include chronic pain, HIV, HCV,
SUD, LGBTQ, and pediatrics.
4. Supervision; Weekly individual and groups sessions focused on clinical and professional development
of new providers
5. Quality Improvement Training; Training to a high performance QI model, including front line QI
improvement, data driven QI, and leadership development.
13. Polling Question
Do you currently have a
licensed clinical
psychologist on staff at
your organization?
14. Postdoctoral Clinical Psychology Residency
1. Clinical Practice Experiences; independent clinic sessions in integrated practice
settings
2. Supervision; Weekly individual and group supervision sessions designed to
meet state specific licensing requirements
3. Site-Specific Clinical Team Meetings; Participate in team meetings to discuss
clinical case with the integrated care team
4. Weekly Didactic Sessions; Variety of topics including group therapy, medication
management, substance use, child psychology
5. Quality Improvement Training; Training to a high performance QI model,
including front line QI improvement, data driven QI, and leadership
development.
15. Cost Considerations and Sustainability
Program investment must be viewed as a multi-year life cycle project
Year 1 –
Investment
Year 2 – ROI
Retention of residents
Additional benefits
• Smooth transition to full time practice
already trained to your organization’s system
• Increased productivity post residency
• Reduce recruitment costs for external
candidates
• Increased provider satisfaction for staff
involved in the program
• Creates a network of alumni which can
support future recruitment
16. Experiences from Previous Residents
Garrett Matlick
• Class of 2018-2019
• Transition to Practice
Nicole Seagriff
• Class of 2011-2012
• PCP, Preceptor/Faculty
• Leadership Development
• Staffing- Clinical Leader
18. The Road to Developing a Postgraduate Residency Program
• Answer the question: What are your drivers for starting a postgraduate program?
• Learn the essential elements of a postgraduate program
• Accrediting standards
• State licensing requirements
• Assess your own resources (physical, human, financial)
• Consider creating an academic partnerships
• Secure board, leadership, and clinical buy-in
• Develop financial and strategic plan including potential partners
• Costs and benefits:
• Direct and indirect costs
• Return on Investment: immediate and longer term
• Benefits beyond the financial return
19. To download the digital version of "Training the Next Generation: Residency and
Fellowship Programs for Nurse Practitioners in Community Health Centers"
https://www.weitzmaninstitute.org/NPResidencyBook
20. Website: www.npresidency.com
www.chc1.com
www.weitzmaninstitute.org
Margaret Flinter, APRN, PhD, c-FNP, FAAN, FAANP
Senior VP and Clinical Director
Email: margaret@chc1.com
Charise Corsino, MA
Program Director, NP Residency Training
Email: charise@chc1.com
Nicole Seagriff, DNP, APRN, FNP-BC
Clinical Program Director
Email: Seagrif@chc1.com
Chelsea McIntosh
Training Director, Postdoctoral Residency Program
Email: McIntoc@chc1.com