Home Visits
Home visits have been used in residency programs as a way to fulfill the six core competencies (patient care, medical knowledge, interpersonal and communication skills, practice-based learning, systems-based practice, and professionalism) set forth by the Accreditation Council for Graduate Medical Education (ACGME). Home visits help to inform residents about their patients’ home lives and allow physicians to better tailor medical advice to the patients. Additionally, the literature has also shown that home visits are appreciated by parents as a way to minimize boundaries between the family and the provider. As part of your ongoing community medicine exposure in the Social Pediatrics Program all residents are going to have the opportunity to visit families of our patients in their own environments, in their homes through our home visiting experience.
Goals and Objectives:
Goal: Increase residents’ knowledge of the interface of biological, psychological, familial and social context presented by patients and families
Goal: Enrich the doctor-patient relationship, through a greater understanding of the environment/context in which children and families in the Bronx live.
Learning Objectives: At completion of the social pediatrics home visit the learner will demonstrate competency in:
1.) Demonstrating an enhanced understanding of the doctor-patient relationship.
2.) Describing a broad conceptualization of health that includes the integration of psychosocial issues.
3.) Broaden your knowledge of cultural health beliefs and practices
When will the Social Pediatric resident have a home visit?
Each PGY-2 and PGY-3 will have at least one home visit per year. Home visits will take place on Tuesdays. There will be 2 residents who will each select a family to visit, along with 1-2 faculty members (including Dr. Tanya White-Davis when possible).
How should you choose a family?
You will choose a family to visit, call them and arrange the time we’ll be coming. Pick any family you would like to get to know better, even one with healthy kids. There are no restrictions on the types of families we can visit. Some of the most memorable visits have been with newborn babies, families with multiple generations living together, teenage parents and children with special health care needs.
When should you call the family?
Once you know the home visit is coming up think of a few families you might like to visit. You can invite them to participate in the home visit program when you see them in the office or you can call them. You should make as many attempts necessary until you have reached someone who can be visited that day. Please ask for guidance from one of your preceptors and/or Dr. White-Davis if you encounter any issues or have any questions during this step.
What should you say?
Tell the family that you will be going on home visits with some of your colleagues and an attending you work with. Say you’d like to get to know the family a little better, meet the other members in the household and learn things from them that you could suggest to other families. It will mostly be a social visit but also can include health topics if pertinent- e.g. possible triggers for a known child with asthma or environmental risk factors for an elevated lead. You may emphasize that this is an opportunity for families to ask questions/discuss topics with a team of providers that they may have missed in previous visits or are curious. If families seem concerned about your motives, reassure them that this isn’t part of a child protection investigation. Check if they can be flexible about being home on the afternoon of the scheduled day.
Once you have a family, what should you do next?
Be sure to confirm the address, ask for the cross streets and find out any special instructions once you reach the front door. Make sure to check all ways of contacting the family (home and cell #s). Email the chief resident so that we can plan our route from the hospital.
What if you are having trouble arranging a home visit?
Most of the time, families are delighted to receive this invitation/offer and feel honored that you have chosen them. On rare occasions a family is uncertain about opening its home to you. Follow your instincts in the conversation. Let the social pediatrics faculty, Dr. Bathory and Dr. White-Davis know if you’re having trouble setting up a visit with enough advance notice for us to make the most of this opportunity. Please call or email with any questions.