Integrating Home Visits into GME: A Multi-Program Perspective

Home visits are largely absent from internal medicine graduate medical education. A 2001 review found only 25% had mandatory home visit training and one-third offered no instruction at all. Further, a needs assessment found that residents did not feel prepared to make home visits despite a desire to do so. Home-based care effectively allows residents to develop skills in each of the key ACGME competencies, with potential to be an important and efficient part of training. Additionally, with shifts to X+Y schedules, home visits provide experiential learning opportunities during immersive two-week ambulatory blocks as well potential pop off valves for clinic scheduling. Home visits have become an integral part of ambulatory education for residents in residency programs. In this workshop, presenters will provide an overview of the evolution of these programs, lessons learned, and data describing the impact of these programs on patients, learners, and communities. Workshop leaders will present a spectrum of approaches, ranging in duration, institutional support, and interdisciplinary team integration and present a framework for home visit program development. In small groups, participants will brainstorm existing and needed resources within institutions, foreseeable barriers, and actionable next steps. The group will reconvene to discuss takeaways and potential inter-program collaboration opportunities. Participants will leave with an individualized toolkit for developing a home visit program at their institution.