2546. The Mentor Model: Improving Fellow-Level Transitions of Patient Care

BACKGROUND: Our infectious disease fellows rarely see follow-up patients. Yet longitudinal patient care teaches the fellow how to approach chronic illnesses, continued clinical decline, and adverse effects of antimicrobial therapy. Fellows at our institution typically rotate with a different faculty member every 1–2 weeks. Follow-up visits are scheduled with the faculty member. While this model exposes the fellow to a variety of cases and management styles, it limits fellow follow-up opportunities. We developed a model to solve this problem. METHODS: The Mentor Model involves 12-week blocks during which the fellow and a faculty member share the same schedule, facilitating fellow participation in post-discharge visits, re-consultations, and repeat outpatient appointments. We queried our electronic medical record for a list of all consult notes written by fellows during both Mentor Model and traditional (non-Mentor Model) blocks. The number of repeat encounters, or evaluations of an established patient, were tallied and divided by the number of total encounters to determine each fellow’s follow-up rate. This value was compared between Mentor Model and non-Mentor Model blocks. RESULTS: Historically, our fellows have reported 1–2 follow-ups each over the course of his or her training. Four first-year fellows rotated through two Mentor Model blocks totaling 23 weeks and several non-Mentor Model blocks totaling 14 weeks within the study period. Fellow follow-up rates ranged from 5–12% during non-Mentor Model blocks. One fellow demonstrated increased rates during the first Mentor Model block (5% vs. 9%) and three demonstrated increased rates during the second Mentor Model block (5–11% vs. 9–18%). The most encounters noted for a single patient was five. The majority of repeat encounters occurred in the outpatient setting. CONCLUSION: We describe a rotation model designed to improve continuity of patient care among first-year Infectious Disease fellows at our institution. Compared with our previous rotation schedule, the Mentor Model increased fellow follow-ups. Structural changes to promote longitudinal patient care experiences are described in outpatient-heavy training programs. Further interventions to improve fellow follow-up rates in all training programs are merited. [Image: see text] DISCLOSURES: All authors: No reported disclosures.