The document describes 4 projects that received Challenge Grants from 2008-2009 focused on improving patient-centered care: 1) The TAP project at UCSF developed a transition program for adolescents with chronic conditions moving to adult care including resident training, a transition handbook for patients, and found a need for improved transition preparedness. 2) The IPR project at Medical College of Georgia implemented and measured patient-centered rounds on medicine units, identifying strategies to overcome obstacles and a blueprint for wider adoption. 3) The Resident Performance project at Carillion Clinic adapted an evaluation tool for patients to assess residents' competencies, finding it reliable for comprehensive feedback. 4) The Patient-Centered

1. Challenge Grant Program Cycle: 2008-2009
Transitioning Adolescent Patients (TAP) from Pediatric to Adult Care
Principal Investigator: Emily von Scheven, MD, MAS, Pediatric Rheumatology, University of California San
Francisco
The TAP project developed an institution-wide program to facilitate the transition of adolescent
patients with chronic health care needs from pediatric- to adult-centered care. There were two
core initiatives: resident training in core competencies for transitional care, and the development
of a “Transition Handbook,” that were provided as a three-ring binder to adolescent patients in
order to teach self-management skills. The content of the Transition Handbook was reviewed and
critiqued by a group of adolescent patients prior to distribution. Investigators expectation was
that the handbook would improve quality of care, as measured by surveys of provider knowledge
and patient reports. Final Analysis/Dissemination include: As a result of their survey,
combined with their “Transition handbook”, it was concluded that there is a tremendous need for
providers to be trained in transition care. It was also found that many of their patients were not
ready to assume responsibility for their health care, and were in need of an educational
intervention. The results of the transition readiness survey are currently being prepared for
publication. Application has been made to the Lupus Foundation of American to obtain funding
to test the impact of the pediatric Lupus Health Passport in a pilot study across three North
American sites.
Improving Patient Rounds (IPR)
Principal investigator: Walter J. Moore, MD, Center for Patient- and Family-Centered Care, Medical College
Georgia
The IPR project’s goal was to initiate patient- and family-centered- care rounds in adult medical
and surgical rounds. Project initially followed and measured improvement of one service team,
practicing patient- and family-centered rounds, on the inpatient medicine unit, with attention to
patient, family, staff and physician satisfaction; unit costs; resident and unit efficiency; and
quality and safety. Educational effectiveness and team performance in PFCC rounds were
evaluated through student/faculty culture survey (pre/post), written evaluations, and student
debriefing and videotaped session(s). Project results included identifying steps and strategies
applicable to other adult-care units, and discovering and overcoming specific obstacles in PFCC
rounds. Results plans included developing into a blueprint for use in MCG units and other
institutions. Final Analysis/Dissemination include: Results from the IPR project show that
interdisciplinary PFCC teaching rounds can work on a general medicine unit in adult care, with
adequate support from institutional leadership, committed attending physicians, nursing
leadership and front-line nursing staff as well as patients and their families. They plan on
implementing bedside PFCC Rounds as a standard practice in the adult care hospital. In March
of 2010, PFCC Rounds experiences will be incorporated into MCG’s PFCC Annual conference.
Resident Performance from the Patient’s View
Principal investigator: Dick M. Wardrop, MD, PhD, FAAP, Director of Resident Research, Internal Medicine,
Carillion Clinic, Roanoke, Va.
The Resident Performance project intended to adapt an existing attendant-based evaluation into a
patient-centered prototype tool that is concise, valid and reliable, and that enables patients to
accurately assess resident performance on 4/6 ACGME competencies. Performance with regard

2. to ACGME core competencies of residents who receive feedback and coaching using the patient-
centered tool was compared to that of those who received attending-only feedback. Final
Analysis/Dissemination include: Through their testing, it was found that their project tool was
reliable with single scale structural validity in a system of comprehensive evaluation and
feedback in patient-centered ACGME competency domains. This data has been presented both
locally at Carilion, and nationally at the ACGME meeting in Texas in 2009. They are also
submitting their project to the peer-reviewed Journal of Graduate Medical Education.
Patient-Centered Training of Residents on a Medical Ward
Principal investigator: Robert C. Smith, MD, MS, Internal Medicine,
EW Sparrow Hospital/Michigan State University College of Human Medicine
The patient-centered training project intended to establish integrated patient-centered-care teams
of project faculty and nursing staff to direct residents on a dedicated patient-centered-care ward.
Project included two visits from outside consultant Dr. Richard Frankel for the purpose of
developing integrated-care teams and a method for delivering patient-centered care. Dr. Frankel
worked with project faculty, nurse teachers and hospital administration, with a focus on
strategies for becoming successful change agents. Success of patient-centered care delivery was
to be determined by descriptive and patient-specific data. Final Analysis/Dissemination
include: Data collected concluded that the academic ward is disproportionately serving
underserved or indigent “no-doc” patients compared with other units. Providers working with
these populations may experience higher levels of stress. Therefore, additional support for
providers is of the utmost importance, as well as looking at systematic ways to improve patient-
centered care, such as literacy levels of patient education materials. Dr. Laird-Fick presented this
project at the ACGME conference in Texas in March. Dr. Smith gave an oral presentation about
the educational model at the International Conference on Communication in Healthcare in
October 2009.