An age-friendly chart review tool: integrating geriatrics education and quality improvement in a resident primary care clinic.

Abstract

Resident primary care clinics have no standardized approach for assessing geriatric-specific quality of care measures. This results in wide variability in the quality of care offered to older adults in these clinics and the quality of geriatrics education residents receive in the primary care setting. To address this need, we developed a structured resident self-assessment chart review tool designed to be integrated into a required Geriatrics rotation within an Internal Medicine residency program. Review of the completed chart review tools revealed gaps in resident documentation of geriatric-specific domains, with assessments of cognition, function, and sensory ability most likely to be missing. Qualitative review of open-ended comments included in the chart review exercise identified documentation of patient goals and values as high clinical priority, while documentation of a cognitive assessment was considered to be of low clinical priority. By integrating improving quality of care with resident education, the chart review tool may offer an effective and time-efficient strategy for better patient care, increasing geriatric-specific education within primary care and helping educators identify areas of priority for future curriculum development.