Canandaigua Veterans Administration Medical Center

Direct Patient Care PGY-2 and PGY-3

1. Identify, work up, treat, and follow-up common outpatient adult and pediatric problems, such as hypertension, diabetes, hyperlipidemia, obesity, CAD, acute and chronic musculoskeletal injuries, headache, dizziness, abdominal pain, UTI’s, rashes, viral illnesses, asthma, and tobacco abuse.
2. Perform adult health maintenance exams and implement important preventive measures.
3. Perform common minimally invasive procedures done in primary care practices, such as EKG interpretation, spirometry, IM/SC injection, phlebotomy on adults, toenail removal, cast or splint application, and foreign body removal.
4. Access various sources of information to fill primary care knowledge gaps.
5. Identify clinically important knowledge gaps and demonstrate the ability to fill gaps in real time using quick reference material.
6. Clearly and succinctly present patient information to communicate and coordinate patient care with hospitals and specialists through phone calls, consult letters, and reports.
7. Delegate responsibility as it applies to a Patient Aligned Care team (PACTs)—the VA’s Medical Home.
8. Teach, negotiate with, and communicate with patients around issues of self-monitoring and self-managing acute and chronic diseases.
9. Communicate clearly and compassionately with patients and their families about difficult issues, such as medical decision making and delivering bad news.
10. Demonstrate sensitivity and responsiveness to the unique personal and cultural situation of each patient, and provide care respecting each patient’s personal values and goals.
11. Appropriately assign E/M codes and complete billing/encounter forms, demonstrating an understanding of outpatient primary care office finances and documentation as it relates to insurance billing, collection rates, managed care organizations, and physician organizations.

Quality Improvement PGY-3

1. Apply knowledge about hospital/health system policy development, adoption, implementation and evaluation, regarding quality assurance and improvement.
2. Apply knowledge about the development, implementation and evaluation of activities/programs to ensure patient safety and prevent medical complications in the population treated at the VA, such as nosocomial infections
3. Synthesize progress on above by communicating on a regular basis with staff and leadership on progress designing, implementing and evaluating quality improvement initiatives in order to inform and engender support for such efforts.