Theme: Patient Safety
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Patient safety and quality leadership scholars program: Creating human infrastructure for teaching safety and quality
Authors: F. Jacob Seagull Ph.D.
Patricia Mullan Ph.D.
Larry Gruppen Ph.D.
R. Van Harrison Ph.D
Institutions: Department of Medical Education - University of Michigan Medical School
 
Background

Safety and Quality Work Pyramid

 

Recent safety and quality initiatives in the U.S.A.
-Part IV maintenance of certification
-ACGME CLER requirements for teaching safety and quality
-AAMC “Teaching for Quality”
 
These initiatives created a demand for qualified faculty to deploy a curriculum for safety and quality improvement
 
Not enough faculty qualified to teach such a curriculum.

The University of Michigan Medical School has established a Patient Safety and Quality Leadership (“PASQUAL”)  Scholars Program
-for medical school faculty who wish to become clinical leaders in quality and patient safety
-funded internally as a faculty development initiative
-administered through the Office of Faculty Affairs
 
The Program provides an academic and applied foundation in principles and methods for:
-quality improvement
-patient safety
-leadership
-teaching
-scholarship
 
Graduates of this program will be well positioned to
-direct quality and safety initiatives
-facilitate education
-conduct research /scholarship on quality and safety in patient care.
Summary of Work

 

1. Formal curriculum

  Formal sessions were conducted in weekly 3.5 hour afternoon seminars over a 5 month period. University of Michigan Faculty and visiting faculty with expertise in quality and safety leadership and research conduct these weekly sessions. Sessions are designed to be interactive, supported by readings and application exercises.  Core components of the curriculum include the following:

Quality Improvement:  a solid understanding of quality improvement theory and practice, including the Michigan Quality System’s Lean Thinking principles and methods, as well as other approaches to quality improvement.

Patient Safety:  safety science, including systems theory; theories of error and resilience; root cause analysis; and non-technical skills such as communication and teamwork.

Leadership:  an understanding and skills to align and lead the implementation of safety and quality programs, including leadership skills, strategic alignment of goals, organizational change, group work, and mentorship.

Teaching:  educational theory and practical techniques applied to teaching others formally and informally about basic principles and methods for improving safety and quality in patient care.

Scholarship:  methods for applied research and evaluation studies in quality and safety, exploration of research trends, and the presentation and publication of scholarly work in safety and quality.

 

2. Consultants and Visiting Faculty

  The Scholars have access to quality and safety experts who serve as consultants to guide the Scholars through the program and advise and assist them with their quality and safety projects as needed.  The consultants include experts at the University of Michigan as well as visiting faculty from outside the University.

 

3. Hands-on Project

  Scholars identified a new or existing issue in quality or safety relevant to their interests and developed or refined the project to improve safety and/or quality.  This project provided the scholar with an opportunity to apply the principles, skills, and methods acquired in the program and to develop a scholarly approach to safety and quality.  Scholars were expected to present projects and their results at local, regional, and national quality and safety meetings.

 

4. Peer Group of Scholars

  The scholar cohort share formal learning sessions, work together in small group approaches to learning, and interact and collaborate with each other on safety and quality issues and projects.  The peer group of scholars will expand as additional faculty participate in future offerings of the program. 

Summary of Results

 

Curriculum Structure

Participants’ Areas of Specialty

        OB/GYN

        Emergency Medicine

        General Medicine (Hospitalist)

        Pediatrics (NICU)

        Physical Medicine and Rehabilitation

        Pathology

        Otolaryngology

        Anesthesiology

Safety and QI Projects (examples)

        Pathology lab OPPE quality metrics

        Multi-disciplinary rounds

        On-time starts of scheduled cesarean deliveries

        Handoffs in the Emergency Department

        Discharge summary process

        Medication reconciliation process

        Case-review process

        Tracheostomy care

Conclusion

Strengths

 

Addresses an institutional need for teachers of QI

-Creates an infrastructure of faculty physicians who
Teach quality and safety
Lead such initiatives, conduct scholarly work

 Area for improvement

-Transitioning scholars from theory to practice
-Incorporating scholarship into QI/PS activities

Feasibility of maintaining program, and transfer to other settings

-Solid curriculum framework can be adapted to any other institution
-Success is dependent on:
Finding qualified teachers
Having an institutional commitment to providing resources to carry out the program
Take-home Messages

This scholars program provides an effective model curriculum for developing the human capital needed to teach PS/QI. 

 

For more information, please contact: jseagull@umich.edu

Background
Summary of Work
Summary of Results
Conclusion
Take-home Messages
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