• Acad Med · Jan 2021

    Creating a Framework to Integrate Residency Program and Medical Center Approaches to Quality Improvement and Patient Safety Training.

    • Anders Chen, Benjamin J Wolpaw, Lisa K Vande Vusse, Chenwei Wu, Nicholas Meo, Milner B Staub, Katherine G Hicks, Stephanie A Carr, Anneliese M Schleyer, Robert D Harrington, and KleinJared WJWJ.W. Klein is internal medicine representative, Medical Quality Improvement Committee, Harborview Medical Center, and assistant professor of medicine, University of Washington School of Medicine, Seattle, Washington..
    • A. Chen was assistant program director, Health Systems and Quality Improvement, Internal Medicine Residency Program, University of Washington School of Medicine, Seattle, Washington, at the time this work was completed. He is curriculum and pathway director, Health Systems and Quality Improvement, Internal Medicine Residency Program, and assistant professor of medicine, University of Washington School of Medicine, Seattle, Washington.
    • Acad Med. 2021 Jan 1; 96 (1): 75-82.

    AbstractQuality improvement and patient safety (QIPS) are core components of graduate medical education (GME). Training programs and affiliated medical centers must partner to create an environment in which trainees can learn while meaningfully contributing to QIPS efforts, to further the shared goal of improving patient care. Numerous challenges have been identified in the literature, including lack of resources, lack of faculty expertise, and siloed QIPS programs. In this article, the authors describe a framework for integrated QIPS training for residents in the University of Washington Internal Medicine Residency Program, beginning in 2014 with the creation of a dedicated QIPS chief resident position and assistant program director for health systems position, the building of a formal curriculum, and integration with medical center QIPS efforts. The postgraduate year (PGY) 1 curriculum focused on the culture of patient safety and entering traditional patient safety event (PSE) reports. The PGY-2 curriculum highlighted QIPS methodology and how to conduct mentored PSE reviews of cases that were of educational value to trainees and a clinical priority to the medical center. Additional PGY-2/PGY-3 training focused on the active report, presentation, and evaluation of cases during morbidity and mortality conferences while on clinical services, as well as how to lead longitudinal QIPS work. Select residents led mentored QI projects as part of an additional elective. The hallmark feature of this framework was the depth of integration with medical center priorities, which maximized educational and operational value. Evaluation of the program demonstrated improved attitudes, knowledge, and behavior changes in trainees, and significant contributions to medical center QIPS work. This specialty-agnostic framework allowed for training program and medical center integration, as well as horizontal integration across GME specialties, and can be a model for other institutions.Copyright © 2020 by the Association of American Medical Colleges.

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