Click here for an article from Academic Physician & Scientist about the Gold Foundation and the Home Visit Program.

In years past, a house call was a standard practice that increased physicians' awareness of many factors influencing their patients' health, created strong doctor-patient relationships, and provided a valuable service to those who were sick and frail. While in today's healthcare climate such home visits are not practical for most physicians, there is still a great deal which can be gained from an opportunity to be a guest in the home of a patient, and to see the practical barriers to good healthcare.

The richness of a home visit, both as a clinically useful intervention and as an invaluable teaching tool, cannot be underestimated. The Home Visit Program provides residents with an opportunity to expand their understanding of their patients' social history by seeing living situations, neighborhoods and community settings firsthand. Information gained from such a visit will expand a resident's understanding of a wide variety of issues, from compliance, to safety, to issues of death and dying. Residents participating in the program become more aware of how their patients' living conditions, caregivers and socioeconomic status impact upon their illnesses.

The Gold Foundation is hopeful that once young physicians have experienced the benefits of a home visit for both themselves and their patients, they might be willing to include such visits in future medical practice when appropriate. The Gold Foundation Home Visit Program for Residents was created to provide this experience. In the words of one faculty mentor "the residents will never again look at their patients in the same, standard clinical framework to which we have all become far too accustomed."

The Home Visit Program for Residents has several important goals:

• to teach residents the value of home visits, including, the opportunity to understand complex issues affecting their patients' health, the modification of the usual doctor-patient dynamic, and development of cultural competencies
• to provide residents with the necessary skills to carry out home visits
• to provide role models to the residents via the Home Visit faculty advisors
• to allow residents to learn from their peers, and to develop team-building skills
• to provide improved healthcare to the patients participating in the Home Visit Program

The five core components for the Gold Foundation Home Visit Program model include the following.

• A dedicated, experienced, role-model faculty mentor should participate in each home visit to facilitate learning and oversee all aspects of the visit.
• Several residents (suggested are between two and five) must participate in each visit to ensure that peer learning and team building skills are encouraged.
• Residents should participate in at least two home visits per year, or a total of six during the course of their residency training.
• Time must be built into the visit day for reflective discussions and teaching to take place, both prior to and following the visit. We encourage Home Visit Program teams to share a meal at the conclusion of the visit schedule to facilitate this process.
• Patients should be chosen from the residents' own continuity patients to ensure a rich learning experience, enhance the doctor-patient relationship, and provide for improved future care for the patient. Patients should not be strictly homebound.

Home Visit Program for Residents Grant Application Guidelines