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Description
Continuity of care in pediatric residency clinics is an ACGME core principle in pediatric residency programs and benefits both patients and residents. Most pediatric residency programs struggle to achieve high rates of continuity in residency clinics due to the scheduling challenges and competing inpatient responsibilities inherent to residency. Prior to this quality improvement (QI) intervention, the Academic Pediatric Residency Clinic (APRC) at this institution demonstrated around a 4% continuity rate. This QI project aimed to increase the patient continuity rate, as defined by the percentage of patient visits occurring with the assigned primary care provider (PCP), in the APRC from a baseline of 4.8% to over 30%.
In response to the identification of low continuity rates, multiple interventions targeted at barriers to patient continuity were implemented in the APRC (Figure 1). The electronic health record was used to create a report to stratify >20,000 patient encounters with over >100 providers over 22 months, into "visits with assigned PCP" vs "visits with a non-PCP physician." A run chart was created to analyze data from February 2024 to November 2025.
An overall increase in continuity from 4.8% in February 2024 to 39.1% in November 2025 was achieved. Three periods of decreased continuity were observed, and improvement was most rapid from July 2025 to November 2025 (Figure 2).
Over the course of interventions targeting barriers to patient continuity in the APRC, the percentage of patient encounters with a PCP trended significantly upwards. With continued implementation and future PDSA cycles, the next goal is achieving 50% continuity by July 2026. Future cycles include expansion of the newborn pilot program, standardization of note templates, and increased resident ownership of patient panels. Future work will assess the effects of improved continuity on resident satisfaction with the Academic Pediatric Residency Clinic.
Publication Date
5-8-2026
Disciplines
Pediatrics
Recommended Citation
Moody G, Buckley C, Liu K, Link K, Schafer C, Hillard M, Kilpatrick C, Sieplinga K. Continuity counts: A quality improvement initiative to increase the continuity of care in an academic pediatric residency clinic. Presented at: Research Day Corewell Health West; 2026 May 8; Grand Rapids, MI.
Comments
2026 Research Day Corewell Health West, Grand Rapids, MI, May 8, 2026. Abstract 2120