Toolkit for Implementing the Chronic Care Model in an Academic Environment

Learning from Resident Push-Back

Letting residents voice their concerns about projects geared toward the Chronic Care Model let them shape the project and gain their support.

Learning from Resident Push Back

The challenges encountered by the Vanderbilt University Medical Center team while implementing their approach included:

  • Helping providers accept disappointing practice data.
  • Developing solutions to problems that made sense to providers.
  • Motivating residents to take ownership of the project.
  • Presenting change concepts as applicable to sub-specialists as well as residents interested in primary care.

By remaining open to and learning from resident push back, the team identified successful aspects of their approach that helped garner resident support, such as:

  • Using fellow residents to teach system change concepts.
  • Minimizing jargon and "system change speak."
  • Working on problems relevant and important to residents.
  • Allowing residents to implement their own ideas through resident-initiated and -driven projects (plan-do-study-act cycles).

Consequently, residents are incorporating new behaviors in their practice and are pleased with their improved ability to help patients set goals. Residents are applying change concepts to new areas of diabetes care (such as hyperlipidemia and obesity) and are teaching the Chronic Care Model to faculty and others not involved in the collaborative through their practice of the model.

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Page last reviewed October 2014
Page originally created January 2008
Internet Citation: Learning from Resident Push-Back. Content last reviewed October 2014. Agency for Healthcare Research and Quality, Rockville, MD.