Enhancing Resident Education by Embedding Improvement Specialists Into a Quality and Safety Curriculum-Reference-Cited by-同舟云学术

Enhancing Resident Education by Embedding Improvement Specialists Into a Quality and Safety Curriculum

Published:2023-06-01 Issue:3 Volume:15 Page:348-355
ISSN:1949-8357
Container-title:Journal of Graduate Medical Education
language:en
Short-container-title:

Author:

Levy Kathryn L.¹^ORCID,Grzyb Katie²,Heidemann Lauren A.³^ORCID,Paliani Debra Burke⁴,Grondin Christopher⁵^ORCID,Solomon Gabriel⁶^ORCID,Spranger Elizabeth⁷,Ellies Tammy⁸,Ratz David⁹,Houchens Nathan¹⁰^ORCID

Affiliation:

1. Kathryn L. Levy, MD, is Assistant Professor, Departments of Internal Medicine and Pediatrics, and Associate Program Director, Internal Medicine and Pediatrics Residency, University of Michigan

2. Katie Grzyb, BSE, MHSA, is Continuous Improvement Specialist, Department of Internal Medicine, University of Michigan

3. Lauren A. Heidemann, MD, MHPE, is Associate Professor, Department of Internal Medicine, University of Michigan and Veterans Affairs Ann Arbor Healthcare System

4. Debra Burke Paliani, MSME, is Continuous Improvement Specialist, Quality Department, University of Michigan Health System

5. Christopher Grondin, MD, is Assistant Professor, Department of Internal Medicine, University of Michigan and Veterans Affairs Ann Arbor Healthcare System

6. Gabriel Solomon, MD, is Assistant Professor, Department of Internal Medicine, University of Michigan and Veterans Affairs Ann Arbor Healthcare System

7. Elizabeth Spranger, BA, is Continuous Improvement Specialist, Department of Internal Medicine, University of Michigan

8. Tammy Ellies, MBA, PMP, is Continuous Improvement Specialist, Department of Internal Medicine, University of Michigan

9. David Ratz, MS, is Statistician, Center for Clinical Management Research, Veterans Affairs Ann Arbor Healthcare System

10. Nathan Houchens, MD, is Associate Professor, Department of Internal Medicine, and Assistant Program Director, Internal Medicine Residency Program, University of Michigan and Veterans Affairs Ann Arbor Healthcare System

Abstract

ABSTRACT Background Quality improvement and patient safety (QIPS) curricula are critical in graduate medical education, yet barriers limit the educational experience and project outcomes. Objective To explore the impact of QIPS curricular enhancements and integration of continuous improvement specialists (CIS) by examining the A3 document, the primary project product and surrogate for project quality. Methods Since 2009, University of Michigan internal medicine and medicine-pediatric residents participate in a QIPS curriculum, which includes a 4-week group project. In 2016, residency leaders collaborated with CIS staff, non-clinical experts in QIPS with backgrounds in engineering and business, to improve the curriculum. Informed by a needs assessment, the intervention was implemented in 2017 and consisted of a set of enhancements including integration of CIS staff into groups as co-facilitators. In this retrospective cohort study, a blinded reviewer evaluated all available A3 documents before and after the intervention using a quantitative analysis tool. Results All residents participated in the curriculum during the pre-intervention (July 2009 to June 2016, n=351) and post-intervention (July 2017 to June 2020, n=148) periods. A total of 23 of 84 (27%) pre-intervention and 31 of 34 (91%) post-intervention A3 documents were available for review. Scores improved significantly for 17 of 23 (74%) A3 items and for 7 of 8 (88%) sections. Mean A3 total scores increased from 29.0 to 47.0 (95% CI 12.6-23.4; P<.001) out of a possible 69.0. Conclusions Embedding CIS experts into residency QIPS curricula is associated with improved A3 document quality.

Publisher

Journal of Graduate Medical Education

Subject

General Medicine,Education

Link

https://meridian.allenpress.com/jgme/article-pdf/15/3/348/3249152/i1949-8357-15-3-348.pdf

Reference37 articles.

1. Nasca TJ, Philibert I, Brigham T, Flynn TC. The next GME accreditation system—rationale and benefits. N Engl J Med. 2012; 366(11): 1051- 1056. doi:https://doi.org/10.1056/NEJMsr1200117

2. Conway PH, Clancy C. Transformation of health care at the front line. JAMA. 2009; 301(7): 763- 765. doi:https://doi.org/10.1001/jama.2009.103

3. Weiss KB, Bagian JP, Wagner R. CLER pathways to excellence: expectations for an optimal clinical learning environment (executive summary). J Grad Med Educ. 2014; 6(3): 610- 611. doi:https://doi.org/10.4300/JGME-D-14-00348.1

4. Accreditation Council for Graduate Medical Education. Common program requirements. Accessed February 19, 2020. https://www.acgme.org/What-We-Do/Accreditation/Common-Program-Requirements

5. Djuricich AM, Ciccarelli M, Swigonski NL. A continuous quality improvement curriculum for residents: addressing core competency, improving systems. Acad Med. 2004; 79(suppl 10): 65- 67. doi:https://doi.org/10.1097/00001888-200410001-00020