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Professional Formation of Physicians Focused on Improving Care

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Pediatric and Congenital Cardiac Care

Abstract

There is evidence that many patients do not receive optimum care despite efforts to improve health care quality. Society expects physicians to improve care for their patients, and to lead and function as members of quality improvement (QI) teams. A range of educational approaches exist to prepare physicians for this important role. Education in QI across the educational continuum is supported by the requirements of educational accrediting organizations and the expectation of specialty certification board. These regulatory bodies expect that physicians develop these skills during training, and that physicians in practice maintain QI competence, and assess and improve their patients’ care. At the same time, no coordinated curriculum for teaching QI across the continuum of medical education exists to date. An effective approach to QI education encompasses both didactics and immersive experiences that enable learners to apply their developing competence to real-world problems. Given the importance of team-based approaches in the care of complex patients, new multidisciplinary QI approaches, informed by research on what makes care effective, will contribute to care that improves the patient experience. These will be supported by advances in medical training and assessment, healthy populations, and will lead to improved quality and lower per capita cost of health care to benefit patients and society.

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References

  1. Donabedian A. Evaluating quality of medical care. Milbank Q. 1966;44:166–206.

    Google Scholar 

  2. Wennberg JE. Variation in use of medicare services among regions and selected academic medical centers: is more better? New York: New York Academy of Medicine; 2005.

    Google Scholar 

  3. Mangione-Smith R, DeCristofaro AH, Setodji CM, et al. The quality of ambulatory care delivered to children in the United States. N Engl J Med. 2007;357(15):1515–23.

    CAS  PubMed  Google Scholar 

  4. Fisher ES, Wennberg DE, Stukel TA, et al. Variations in the longitudinal efficiency of academic medical centers. Health Aff (Millwood). 2004;23.

    Google Scholar 

  5. Committee on Quality of Health Care in America, Institute of Medicine. Crossing the quality chasm: a new health system for the 21st century. Washington, DC: National Academies Press; 2001.

    Google Scholar 

  6. Kohn LT, Corrigan JM, Donaldson MS, editors. To err is human: building a safer health system. Washington, DC: National Academy Press; 2000.

    Google Scholar 

  7. Asch DA, Nicholson S, Srinivas S, Herrin J, Epstein AJ. Evaluating obstetrical residency programs using patient outcomes. JAMA. 2009;302(12):1277–83.

    CAS  PubMed  Google Scholar 

  8. Dartmouth Health Atlas, Dartmouth College, Hanover. http://www.dartmouthatlas.org/pages/residency. Accessed 10 Mar 2014.

  9. Gallagher L. Continuing education in nursing: a concept analysis. Nurse Educ Today. 2006;27(8).

    Google Scholar 

  10. Mallon WJ. Ernest Amory Codman: the end result of a life in medicine. Philadelphia: Saunders; 2000.

    Google Scholar 

  11. Cooper M. Quality assurance and improvement. In: Wolper LF, editor. Health care administration: planning, implementing, and managing organized delivery systems. Gaithersburg: Aspen Publishers, Inc; 1999.

    Google Scholar 

  12. Langley GJ, Nolan KM, Norman CL, Provost LP, Nolan TW. The improvement guide: a practical approach to enhancing organizational performance. 2nd ed. San Francisco: Jossey-Bass; 2009.

    Google Scholar 

  13. Berwick DM, Jain SH. The basis for quality care prepaid group practice. In: Enthoven AC, Tollen LA, editors. Toward a 21st century health system: the contributions and promise of prepaid group practice. San Francisco: Jossey-Bass; 2004.

    Google Scholar 

  14. Luce JM, Bindman AB, Lee PR. A brief history of health care quality assessment and improvement in the United States. West J Med. 1994;160(3):263–8.

    CAS  PubMed Central  PubMed  Google Scholar 

  15. Kenney CC. The best practice. New York: Public Affairs Books; 2008.

    Google Scholar 

  16. Batalden PB, Davidoff F. What is “quality improvement” and how can it transform healthcare? Qual Saf Health Care. 2007;16:2–3.

    PubMed Central  PubMed  Google Scholar 

  17. Greiner AC, Knebel E, editors. Health professions education: a bridge to quality. Washington, DC: National Academies Press; 2003.

    Google Scholar 

  18. The Academic Medical Center Working Group of the Institute for Healthcare Improvement. The imperative for quality: a call for action to medical schools and teaching hospitals. Acad Med. 2003;78:1085–9.

    Google Scholar 

  19. Thompson SA, Tilden VP. Embracing quality and safety education for the 21st century: building interprofessional education. J Nurs Educ. 2009;48(12):698–701.

    PubMed  Google Scholar 

  20. Batalden P. Developing health professionals capable of continually improving health care quality, safety and value: the health professional educator’s work. http://www.ihi.org/offerings/ihiopenschool/resources/Pages/ImprovementStories/DevelopingHealthProfessionalsCapableOfContinuallyImprovingHealthCare.aspx. Accessed 10 Mar 2014.

  21. Batalden P, Leach D, Swing S, Dreyfus H, Dreyfus S. General competencies and accreditation in graduate medical education. Health Aff. 2002;21(5):103–11.

    Google Scholar 

  22. Commission on Collegiate Nursing Education. 2002. “CCNE Accreditation.” Online. Available at http://www.aacn.nche.edu/Accreditation. Accessed 10 Mar 2014.

  23. Byrd G. Can the profession of pharmacy serve as a model for health informationist professionals? J Med Libr Assoc. 2002;90(1):68–75.

    PubMed Central  PubMed  Google Scholar 

  24. Leach DC. Competence is a habit. JAMA. 2002;287(2):243–4.

    PubMed  Google Scholar 

  25. Johnson JK, Miller SH, Horowitz SD. Systems-based practice: improving the safety and quality of patient care by recognizing and improving the systems in which we work. In: Henriksen K, Battles JB, Keyes MA, Grady ML, editors. Advances in patient safety: new directions and alternative approaches, Culture and redesign, vol. 2. Rockville: Agency for Healthcare Research and Quality (US); 2008.

    Google Scholar 

  26. Knowles MS. Self-directed learning: a guide for learners and teachers. Englewood Cliffs: Prentice Hall; 1975.

    Google Scholar 

  27. Chatterji M, Graham MJ, Wyer PC. Mapping cognitive overlaps between practice-based learning and improvement and evidence-based medicine: an operational definition for assessing resident physician competence. J Grad Med Educ. 2009;1(2):287–98.

    PubMed Central  PubMed  Google Scholar 

  28. Moskowitz EJ, Nash DB. Teaching trainees the tenets of quality and safety: an annotated bibliography. Am J Med Qual. 2009;24(4):333–43.

    PubMed  Google Scholar 

  29. American Board of Medical Specialties. ABMS® Patient Safety Improvement Program. 2009. http://www.abms.org/Products_and_Publications/pdf/ABMS_PS_ImprovementProgram.pdf. Accessed 10 Mar 2014.

  30. Sachdeva AK, Philibert I, Leach DC, Blair PG, Stewart LK, Rubinfeld IS, Britt LD. Patient safety curriculum for surgical residency programs: results of a national consensus conference. Surgery. 2007;141(4):427–41.

    PubMed  Google Scholar 

  31. Martin L, Joyner, B. IHI Open School as a framework for resident education in safety and quality. Institute for Healthcare Improvement. 2013. http://www.ihi.org/offerings/IHIOpenSchool/resources/Pages/UniversityOfWashingtonResidentEducation.aspx. Accessed 10 Mar 2014.

  32. More Medical and Nursing Schools to Require IHI Open School Basic Certificate. Institute for Healthcare Improvement. 2013. http://www.ihi.org/offerings/IHIOpenSchool/resources/Pages/MoreMedicalAndNursingSchoolsRequireBasicCertificate.aspx. Accessed 17 June 2013.

  33. Houle CO. Continuing learning in the professions. San Francisco: Jossey-Bass; 1980.

    Google Scholar 

  34. Wong BM, Etchells EE, Kuper A, Levinson W, Shojania KG. Teaching quality improvement and patient safety to trainees: a systematic review. Acad Med. 2010;85(9):1425–39.

    PubMed  Google Scholar 

  35. Levitt DS, Hauer KE, Poncelet A, Mookherjee S. An innovative quality improvement curriculum for third-year medical students. Med Educ Online. 2012;17. doi:10.3402/meo.v17i0.18391.

  36. Walton M, Woodward H, Van Staalduinen S, Lemer C, Greaves F, Noble D, Ellis B, Donaldson L, Barraclough B. The WHO patient safety curriculum guide for medical schools. Qual Saf Health Care. 2010;19(6):542–6. doi:10.1136/qshc.2009.036970.

    PubMed  Google Scholar 

  37. Liaison Committee on Medical Education. Functions and structure of a medical school. http://www.lcme.org/functions.pdf. Accessed 10 Mar 2014.

  38. Foundation NPS, Institute LL. Unmet needs: teaching physicians to provide safe patient care. National Patient Safety Foundation; 2010. http://www.npsf.org/about-us/lucian-leape-institute-at-npsf/lli-reports-and-statements/the-patient-safety-imperative-for-health-care-reform/unmet-needs. Accessed 10 Mar 2014.

  39. Aron DC, Headrick LA. Educating physicians prepared to improve care and safety is no accident: it requires a systematic approach. Qual Saf Health Care. 2002;11(2):168–73.

    CAS  PubMed Central  PubMed  Google Scholar 

  40. Weingart SN, Tess A, Driver J, Aronson MD, Sands K. Creating a quality improvement elective for medical house officers. J Gen Intern Med. 2004;19(8):861–7.

    PubMed Central  PubMed  Google Scholar 

  41. Reardon CL, Ogrinc G, Walaszek A. A didactic and experiential quality improvement curriculum for psychiatry residents. J Grad Med Educ. 2011;3(4):562–5.

    PubMed Central  PubMed  Google Scholar 

  42. Akins RB, Handal GA. Utilizing quality improvement methods to improve patient care outcomes in a pediatric residency program. J Grad Med Educ. 2009;1(2):299–303.

    PubMed Central  PubMed  Google Scholar 

  43. Sepulveda D, Varaklis K. Implementing a multifaceted quality-improvement curriculum in an obstetrics-gynecology resident continuity-clinic setting: a 4-year experience. J Grad Med Educ. 2012;4(2):237–41.

    PubMed Central  PubMed  Google Scholar 

  44. Singh R, Naughton B, Taylor JS, Koenigsberg MR, Anderson DR, McCausland LL, Wahler RG, Robinson A, Singh G. A comprehensive collaborative patient safety residency curriculum to address the ACGME core competencies. Med Educ. 2005;39(12):1195–204.

    PubMed  Google Scholar 

  45. Stanton F, Grant J. Approaches to experiential learning, course delivery and validation in medicine. A background document. Med Educ. 1999;33(4):282–97.

    CAS  PubMed  Google Scholar 

  46. Kolb DA. Experiential learning: experience as the source of learning and development. Englewood Cliffs: Prentice Hall; 1984.

    Google Scholar 

  47. Hall LW, Headrick LA, Cox KR, Deane K, Gay JW, Brandt J. Linking health professional learners and health care workers on action-based improvement teams. Qual Manag Health Care. 2009;18(3):194–201.

    PubMed  Google Scholar 

  48. McClain EK, Babbott SF, Tsue TT, Girod DA, Clements D, Gilmer L, Persons D, Unruh G. Use of a structured template to facilitate practice-based learning and improvement projects. J Grad Med Educ. 2012;4(2):215–9.

    PubMed Central  PubMed  Google Scholar 

  49. Folcik MA, Kirton OC, Ivy ME. A two-tiered quality management program: Morbidity and Mortality conference data applied to resident education. Conn Med. 2007;71(8):471–8.

    PubMed  Google Scholar 

  50. Kravet SJ, Howell E, Wright SM. Morbidity and mortality conference, grand rounds, and the ACGME’s core competencies. J Gen Intern Med. 2006;21(11):1192–4.

    PubMed Central  PubMed  Google Scholar 

  51. Stiles BM, Reece TB, Hedrick TL, Garwood RA, Hughes MG, Dubose JJ, Adams RB, Schirmer BD, Sanfey HA, Sawyer RG. General surgery morning report: a competency-based conference that enhances patient care and resident education. Curr Surg. 2006;63(6):385–90.

    PubMed  Google Scholar 

  52. Ogrinc G, Headrick LA, Morrison LJ, Foster T. Teaching and assessing resident competence in practice-based learning and improvement. J Gen Intern Med. 2004;19(5 Pt 2):496–500.

    PubMed Central  PubMed  Google Scholar 

  53. Krajewski K, Siewert B, Yam S, Kressel HY, Kruskal JB. A quality assurance elective for radiology residents. Acad Radiol. 2007;14(2):239–45.

    PubMed  Google Scholar 

  54. Varkey P, Reller MK, Smith A, Ponto J, Osborn M. An experiential interdisciplinary quality improvement education initiative. Am J Med Qual. 2006;21(5):317–22.

    PubMed  Google Scholar 

  55. Hussain KA, Kelton GM. Utilization of health care quality markers in a family medicine outpatient setting. Fam Med. 2006;38(7):490–3.

    PubMed  Google Scholar 

  56. Canal DF, Torbeck L, Djuricich AM. Practice-based learning and improvement: a curriculum in continuous quality improvement for surgery residents. Arch Surg. 2007;142(5):479–82.

    PubMed  Google Scholar 

  57. Frey K, Edwards F, Altman K, Spahr N, Gorman RS. The ‘Collaborative Care’ curriculum: an educational model addressing key ACGME core competencies in primary care residency training. Med Educ. 2003;37(9):786–9.

    PubMed  Google Scholar 

  58. Oyler J, Vinci L, Johnson JK, Arora VM. Teaching internal medicine residents to sustain their improvement through the quality assessment and improvement curriculum. J Gen Intern Med. 2011;26(2):221–5.

    PubMed Central  PubMed  Google Scholar 

  59. Quinn DC, Bingham JW, Garriss GW, Dozier EA. Residents learn to improve care using the ACGME core competencies and institute of medicine aims for improvement: the health care matrix. J Grad Med Educ. 2009;1(1):119–26.

    PubMed Central  PubMed  Google Scholar 

  60. Singleton AF, Bazargan M, Ilagan B, Yan L, Eugenio J. Using resident focus groups to improve subspecialty consultations in a pediatric urgent care setting. J Natl Med Assoc. 2006;98(9):1478–82.

    PubMed Central  PubMed  Google Scholar 

  61. Mohr JJ, Randolph GD, Laughon MM, Schaff E. Integrating improvement competencies into residency education: a pilot project from a pediatric continuity clinic. Ambul Pediatr. 2003;3(3):131–6.

    PubMed  Google Scholar 

  62. Fishbane S, Niederman MS, Daly C, Magin A, Kawabata M, de Corla-Souza A, Choudhery I, Brody G, Gaffney M, Pollack S, Parker S. The impact of standardized order sets and intensive clinical case management on outcomes in community-acquired pneumonia. Arch Intern Med. 2007;167(15):1664–9.

    PubMed  Google Scholar 

  63. Kalanithi L, Coffey CE, Mourad M, Vidyarthi AR, Hollander H, Ranji SR. The effect of a resident-led quality improvement project on improving communication between hospital-based and outpatient physicians. Am J Med Qual. 2013;28(6):472–9.

    Google Scholar 

  64. Association of American Medical Colleges. Integrating quality improvement and patient safety across the continuum of medical education. Report of an Expert Panel. 2013. https://members.aamc.org/eweb/upload/Teaching%20for%20Quality%20Report.pdf. Accessed 10 Mar 2014.

  65. Landers MR, McWhorter JW, Krum LL, Glovinsky D. Mandatory continuing education in physical therapy: survey of physical therapists in states with and states without a mandate. Phys Ther. 2005;85(9):861–71.

    PubMed  Google Scholar 

  66. ANCC (American Nurses Credentialing Center). ANCC accreditation application manual. http://www.nursecredentialing.org/ContinuingEducation/Accreditation/AccreditationProcess.aspx. Accessed 10 Mar 2014.

  67. Marinopoulos SS, Dorman T, Ratanawongsa N, Wilson LM, Ashar BH, Magaziner JL, Miller RG, Thomas PA, Prokopowicz PG, Qayyum R, Bass EB. Effectiveness of continuing medical education, Evidence report/technology assessment no. 149. Rockville: Agency for Healthcare Research and Quality; 2007.

    Google Scholar 

  68. Davis D, O’Brien MA, Freemantle N, Wolf FM, Mazmanian P, Taylor-Vaisey A. Impact of formal continuing medical education: do conferences, workshops, rounds, and other traditional continuing education activities change physician behavior or health care outcomes? JAMA. 1999;282(9):867–74.

    CAS  PubMed  Google Scholar 

  69. Bloom BS. Review effects of continuing medical education on improving physician clinical care and patient health: a review of systematic reviews. Int J Technol Assess Health Care. 2005;21(3):380–5.

    PubMed  Google Scholar 

  70. Mansouri M, Lockyer J. A meta-analysis of continuing medical education effectiveness. J Contin Educ Health Prof. 2007;27(1):6–15.

    PubMed  Google Scholar 

  71. Forsetlun L, Bjørndal A, Rashidian A, Jamtvedt G, O’Brien MA, Wolf FM, Davis D, Odgaard-Jensen J, Oxman AD. Continuing education meetings and workshops: effects on professional practice and health care outcomes. Cochrane Database Syst Rev. 2009. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD003030.pub2/full. Accessed 10 Mar 2014.

  72. Institute of Medicine. Redesigning continuing education in the health professions. Washington, DC: The National Academies Press; 2009.

    Google Scholar 

  73. Miller S. ABMS’ maintenance of certification. Clin Orthop Relat Res. 2006;449:155–8.

    PubMed  Google Scholar 

  74. American Board of Medical Specialties. ABMS maintenance of certification. http://abms.org/Maintenance_of_Certification/ABMS_MOC.aspx. Accessed 10 Mar 2014.

  75. Miller SH, Thompson JN, Mazmanian PE, Aparicio A, Davis D, Spivey B, Kahn N. Continuing medical education, professional development, and requirements for medical licensure: a white paper of the conjoint committee on continuing medical education. J Contin Educ Health Prof. 2008;28(2):95–8.

    PubMed  Google Scholar 

  76. Sumner 2nd W, Truszczynski M, Marek VW. A formal model of family medicine. J Am Board Fam Pract. 1996;9(1):41–52.

    PubMed  Google Scholar 

  77. Holmboe E, Wang Y, Mechan T, et al. Association between maintenance of certification examination scores and quality of care for medicare beneficiaries. Arch Intern Med. 2008;168(13):1396–403.

    PubMed  Google Scholar 

  78. Brennan TA, Horwitz RI, Duffy FD, Cassel CK, Goode LD, Lipner RS. The role of physician specialty board certification status in the quality movement. JAMA. 2004;292(9):1038–43.

    CAS  PubMed  Google Scholar 

  79. Pearce W, Parker M, Feinglass J, Ujiki M, Manheim L. The importance of surgeon volume and training in outcomes for vascular surgical procedures. J Vasc Surg. 1999;299:768–76.

    Google Scholar 

  80. Prystowsky J, Bordage G, Feinglass J. Patient outcomes for segmental colon resection according to surgeon’s training, certification, and experience. Surgery. 2002;132:663–70.

    PubMed  Google Scholar 

  81. Kelly J, Hellinger F. Physician and hospital factors associated with mortality of surgical patients. Med Care. 1986;24:785–800.

    CAS  PubMed  Google Scholar 

  82. The American Board of Surgery, MOC Part 4 – practice assessment resources. http://www.absurgery.org/default.jsp?exam-mocpa. Accessed 10 Mar 2014.

  83. American Board of Pediatrics. Part IV maintenance of certification. http://www.aap.org/en-us/professional-resources/practice-support/quality-improvement/Quality-Improvement-Innovation-Networks/pages/American-Board-of-Pediatrics-Part-4-Maintenance-of-Certification.aspx?nfstatus. Accessed 10 Mar 2014.

  84. ABMS® Patient Safety Improvement Program. http://www.abms.org/Products_and_Publications/pdf/ABMS_PS_ImprovementProgram.pdf. Accessed 10 Mar 2014.

  85. Sachdeva AK. The new paradigm of continuing education in surgery. Arch Surg. 2005;140(3):264–9.

    PubMed  Google Scholar 

  86. Caverzagie KJ, Bernabeo EC, Reddy SG, Holmboe ES. The role of physician engagement on the impact of the hospital-based practice improvement module (PIM). J Hosp Med. 2009;4(8):466–70.

    PubMed  Google Scholar 

  87. Vinci LM, Oyler J, Johnson JK, Arora VM. Effect of a quality improvement curriculum on resident knowledge and skills in improvement. Qual Saf Health Care. 2010;19(4):351–4.

    PubMed  Google Scholar 

  88. Lannon CM, Miles PV, Stockman 3rd JA. The path forward: collaborative networks and the future for children’s health care. Pediatrics. 2013;131 Suppl 4:S226–7.

    PubMed  Google Scholar 

  89. Rappaport DI, Collins B, Koster A, Mercado A, Greenspan J, Lawless S, Hossain J, Sharif I. Implementing medication reconciliation in outpatient pediatrics. Pediatrics. 2011;128(6):e1600–7.

    PubMed  Google Scholar 

  90. Huang JS, Chun S, Sandhu A, Terrones L. Quality improvement in childhood obesity management through the maintenance of certification process. J Pediatr. 2013;26.

    Google Scholar 

  91. Bernabeo EC, Conforti LN, Holmboe ES. The impact of a preventive cardiology quality improvement intervention on residents and clinics: a qualitative exploration. 13. Am J Med Qual. 2009;24(2):99–107.

    PubMed  Google Scholar 

  92. Multispecialty MOC Portfolio Approval Program. http://mocportfolioprogram.org/. Accessed 9 Mar 2014.

  93. Pronovost PJ, Miller MR, Wachter RM, Meyer GS. Perspective: physician leadership in quality. Acad Med. 2009;84(12):1651–6.

    PubMed  Google Scholar 

  94. Pronovost PJ, Goeschel CA, Marsteller JA, Sexton JB, Pham JC, Berenholtz SM. A framework for patient safety research and improvement. Circulation. 2009;119:330–7.

    PubMed  Google Scholar 

  95. Ackerly DC, Parekh A, Stein D. Perspective: a framework for career paths in health systems improvement. Acad Med. 2013;88(1):56–60.

    PubMed  Google Scholar 

  96. Department of Veterans Affairs National Quality Scholars Fellowship Program. http://www.va.gov/oaa/specialfellows/programs/SF_NQSF_default.asp?p=10. Accessed 10 Mar 2014.

  97. Center for Leadership and Improvement, The Dartmouth Institute. http://tdi.dartmouth.edu/faculty/tina-foster-md-mph. Accessed 10 Mar 2014.

  98. Quality Improvement and Outcomes Management in Health Care Systems, Graduate Certificate, George Mason University. http://chhs.gmu.edu/quality/. Accessed 10 Mar 2014.

  99. Baldwin Jr DC. Some historical notes on interdisciplinary and interprofessional education and practice in health care in the USA. 1996. J Interprof Care. 2007;21 Suppl 1:23–37.

    PubMed  Google Scholar 

  100. Institute of Medicine. Educating for the heath team. Washington, DC: National Academy of Sciences; 1972.

    Google Scholar 

  101. Liaison Committee on Medical Education. New Accreditation Standard ED-19-A Approved. http://www.lcme.org/. Accessed 10 Mar 2014.

  102. Headrick LA, Barton AJ, Ogrinc G, Strang C, Aboumatar HJ, Aud MA, Haidet P, Lindell D, Madigosky WS, Patterson JE. Results of an effort to integrate quality and safety into medical and nursing school curricula and foster joint learning. Health Aff (Millwood). 2012;31(12):2669–80.

    Google Scholar 

  103. Batalden P, Davidoff F. Teaching quality improvement: the devil is in the details. JAMA. 2007;298:1059–61.

    CAS  PubMed  Google Scholar 

  104. Westberg SM, Adams J, Thiede K, Stratton TP, Bumgardner MA. An interprofessional activity using standardized patients. Am J Pharm Educ. 2006;70(2):34.

    PubMed Central  PubMed  Google Scholar 

  105. Mitchell PH, Robins Lynn S, Schaad D. Creating a curriculum for training health profession faculty leaders. http://www.ahrq.gov/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety/vol4/Mitchell.pdf. Accessed 10 Mar 2014.

  106. Cleghorn GD, Baker GR. What faculty need to learn about improvement and how to teach it to others. J Interprof Care. 2000;14(2):147–59.

    Google Scholar 

  107. Institute of Medicine. Redesigning continuing education in the health professions. Washington, DC: The National Academies Press; 2010.

    Google Scholar 

  108. Team-Based Competencies: Building a Shared Foundation for Education and Clinical Practice. Macy Foundation. Conference Proceedings. Washington, DC. 2011. http://macyfoundation.org/docs/macy_pubs/Team-Based_Competencies.pdf. Accessed 10 Mar 2014.

  109. Segrave S, Holt D. Contemporary learning environments: designing e-learning for education in the professions. Distance Educ. 2003;24(1):7–24.

    Google Scholar 

  110. Hafferty F. Beyond curriculum reform: confronting medicine’s hidden curriculum. Acad Med. 1998;73:403–7.

    CAS  PubMed  Google Scholar 

  111. Cooke M, Irby DM, O’Brien BC. Educating physicians: a call for reform of medical school and residency. San Francisco: Jossey-Bass; 2010.

    Google Scholar 

  112. Stern DT. In search of the informal curriculum: when and where professional values are taught. Acad Med. 1998;73(10 Suppl):S28–30.

    CAS  PubMed  Google Scholar 

  113. Pingleton SK, Horak BJ, Davis DA, Goldmann DA, Keroack MA, Dickler RM. Is there a relationship between high-quality performance in major teaching hospitals and residents’ knowledge of quality and patient safety? Acad Med. 2009;84(11):1510–5.

    PubMed  Google Scholar 

  114. Weingart SN. House officer education and organizational obstacles to quality improvement. Jt Comm J Qual Improv. 1996;22(9):640–6.

    CAS  PubMed  Google Scholar 

  115. Philibert I, Johnstone MJ. Initiating and sustaining resident involvement in quality improvement: top-down and bottom-up approaches. Chicago: Accreditation Council for Graduate Medical Education; 2008.

    Google Scholar 

  116. Philibert I, Gonzalez del Rey JA, Lannon C, Lieh-Lai M, Weiss KB. Quality improvement skills for pediatric residents: from lecture to implementation and sustainability. Acad Pediatr. 2014;14(1):40–6.

    PubMed  Google Scholar 

  117. Shaikh U, Natale JE, Nettiksimmons J, Li ST. Improving pediatric health care delivery by engaging residents in team-based quality improvement projects. Am J Med Qual. 2013;28(2):120–6.

    PubMed  Google Scholar 

  118. Cooke M, Ironside PM, Ogrinc GS. Mainstreaming quality and safety: a reformulation of quality and safety education for health professions students. BMJ Qual Saf. 2011;20(Suppl_1):i79–82.

    PubMed Central  PubMed  Google Scholar 

  119. Kirkpatrick D. Evaluating training programs: the four levels. San Francisco: Berrett-Koehler; 1998.

    Google Scholar 

  120. Djuricich AM, Ciccarelli M, Swigonski NL. A continuous quality improvement curriculum for residents: addressing core competency, improving systems. Acad Med. 2004;79(10 Suppl):S65–7.

    PubMed  Google Scholar 

  121. Ziegelstein RC, Fiebach NH. “The mirror” and “the village”: a new method for teaching practice-based learning and improvement and systems-based practice. Acad Med. 2004;79(1):83–8.

    PubMed  Google Scholar 

  122. Lyman J, Schorling J, May N, Scully K, Sarafian N, Nadkarni M, Voss J. Customizing a clinical data warehouse for housestaff education in practice-based learning and improvement. AMIA Annu Symp Proc. 2006;1017.

    Google Scholar 

  123. Catalanello R, Kirkpatrick D. Evaluating training programs: the state of the art. Train Dev J. 1968;22(5):2–9.

    Google Scholar 

  124. Reinders ME, Ryan BL, Blankenstein AH, van der Horst HE, Stewart MA, van Marwijk HW. The effect of patient feedback on physicians’ consultation skills: a systematic review. Acad Med. 2011;86(11):1426–36.

    PubMed  Google Scholar 

  125. Boonyasai RT, Windish DM, Chakraborti C, Feldman LS, Rubin HR, Bass EB. Effectiveness of teaching quality improvement to clinicians: a systematic review. JAMA. 2007;298(9):1023–37.

    CAS  PubMed  Google Scholar 

  126. Lee P, Allen K, Daly M. A ‘Communication and Patient Safety’ training programme for all healthcare staff: can it make a difference? BMJ Qual Saf. 2012;21(1):84–8.

    PubMed  Google Scholar 

  127. Woodward CS, Son M, Taylor R, Husain SA. Prevention of sternal wound infection in pediatric cardiac surgery: a protocolized approach. World J Pediatr Congenit Heart Surg. 2012;3(4):463–9.

    PubMed  Google Scholar 

  128. Varughese AM, Adler E, Anneken A, Kurth CD. Improving on-time start of day and end of day for a pediatric surgical service. Pediatrics. 2013;132(1):e219–28.

    PubMed  Google Scholar 

  129. Wheeler DS, Giaccone MJ, Hutchinson N, Haygood M, Bondurant P, Demmel K, Kotagal UR, Connelly B, Corcoran MS, Line K, Rich K, Schoettker PJ, Brilli RJ. A hospital-wide quality-improvement collaborative to reduce catheter-associated bloodstream infections. Pediatrics. 2011;128(4):e995–1004; quiz e1004–7.

    PubMed  Google Scholar 

  130. Blumenthal D, Kilo CM. A report card on continuous quality improvement. Milbank Q. 1998;76(4):625–48.

    CAS  PubMed Central  PubMed  Google Scholar 

  131. Shortell SM, Bennet CL, Byck GR. Assessing the impact of continuous quality improvement on clinical practice: what it will take to accelerate progress. Milbank Q. 1998;76(4):593–624.

    CAS  PubMed Central  PubMed  Google Scholar 

  132. Lynn J. When does quality improvement count as research? Human subject protection and theories of knowledge. Qual Saf Health Care. 2004;13:67–70.

    CAS  PubMed Central  PubMed  Google Scholar 

  133. Reinhardt AC, Ray LN. Differentiating quality improvement from research. Appl Nurs Res. 2003;16(1):2–8.

    PubMed  Google Scholar 

  134. Leape LL, Kabcenell AI, Gandhi TK, Carver P, Nolan TW, Berwick DM. Reducing adverse drug events: lessons from a breakthrough series collaborative. Jt Comm J Qual Improv. 2000;26(6):321–31.

    CAS  PubMed  Google Scholar 

  135. Pronovost PJ, Weast B, Holzmueller CG, Rosenstein BJ, Kidwell RP, Haller KB, Feroli ER, Sexton JB, Rubin HR. Evaluation of the culture of safety: survey of clinicians and managers in an academic medical center. Qual Saf Health Care. 2003;12(6):405–10.

    CAS  PubMed Central  PubMed  Google Scholar 

  136. Kurth CD, Tyler D, Heitmiller E, Tosone SR, Martin L, Deshpande JK. National pediatric anesthesia safety quality improvement program in the United States. Anesth Analg. 2014;119(1):112–21.

    Google Scholar 

  137. Berenholtz SM, Pronovost PJ, Lipsett PA, Hobson D, Earsing K, Farley JE, Milanovich S, Garrett-Mayer E, Winters BD, Rubin HR, Dorman T, Perl TM. Eliminating catheter-related bloodstream infections in the intensive care unit. Crit Care Med. 2004;32(10):2014–20.

    PubMed  Google Scholar 

  138. Johnson T, Currie G, Keill P, Corwin SJ, Pardes H, Cooper MR. NewYork-Presbyterian Hospital: translating innovation into practice. Jt Comm J Qual Patient Saf. 2005;31(10):554–60.

    PubMed  Google Scholar 

  139. Pronovost PJ, Berenholtz SM, Goeschel CA, et al. Creating high reliability in health care organizations. Health Serv Res. 2006;41(4 Pt 2):1599–617.

    PubMed Central  PubMed  Google Scholar 

  140. Pronovost PJ, King J, Holzmueller CG, Sawyer M, Bivens S, Michael M, Haig K, Paine L, Moore D, Miller M. A web-based tool for the Comprehensive Unit-based Safety Program (CUSP). Jt Comm J Qual Patient Saf. 2006;32(3):119–29.

    PubMed  Google Scholar 

  141. Jagsi R, Kitch BT, Weinstein DF, Campbell EG, Hutter M, Weissman JS. Residents report on adverse events and their causes. Arch Intern Med. 2005;165(22):2607–13.

    Google Scholar 

  142. Lypson ML, Frohna JG, Gruppen LD, Woolliscroft JO. Assessing residents’ competencies at baseline: identifying the gaps. Acad Med. 2004;79(6):564–70.

    PubMed  Google Scholar 

  143. Afessa B, Kennedy CC, Klarich KW, Aksamit TR, Kolars JC, Hubmayr RD. Introduction of a 14-hour work shift model for housestaff in the medical ICU. Chest. 2005;128(6):3910–5.

    PubMed  Google Scholar 

  144. Likosky DS, Nugent WC, Ross CS, Northern New England Cardiovascular Disease Study Group. Improving outcomes of cardiac surgery through cooperative efforts: the northern New England experience. Semin Cardiothorac Vasc Anesth. 2005;9(2):119–21.

    PubMed  Google Scholar 

  145. Ohlinger J, Kantak A, Lavin Jr JP, Fofah O, Hagen E, Suresh G, Halamek LP, Schriefer JA. Evaluation and development of potentially better practices for perinatal and neonatal communication and collaboration. Pediatrics. 2006;118 Suppl 2:S147–52.

    PubMed  Google Scholar 

  146. Wagner EH, Glasgow RE, Davis C, Bonomi AE, Provost L, McCulloch D, Carver P, Sixta C. Quality improvement in chronic illness care: a collaborative approach. Jt Comm J Qual Improv. 2001;27(2):63–80.

    CAS  PubMed  Google Scholar 

  147. Martinez EA, Chavez-Valdez R, Holt NF, Grogan KL, Khalifeh KW, Slater T, Winner LE, Moyer J, Lehmann CU. Successful implementation of a perioperative glycemic control protocol in cardiac surgery: barrier analysis and intervention using lean six sigma. Anesthesiol Res Pract. 2011;2011:565069.

    PubMed Central  PubMed  Google Scholar 

  148. Resar RK, Rozich JD, Simmonds T, Haraden CR. A trigger tool to identify adverse events in the intensive care unit. Jt Comm J Qual Patient Saf. 2006;32(10):585–90.

    PubMed  Google Scholar 

  149. Shake JG, Pronovost PJ, Whitman GJ. Cardiac surgical ICU care: eliminating “preventable” complications. J Card Surg. 2013;30.

    Google Scholar 

  150. Shekelle PG, Pronovost PJ, Wachter RM, McDonald KM, Schoelles K, Dy SM, Shojania K, Reston JT, Adams AS, Angood PB, Bates DW, Bickman L, Carayon P, Donaldson L, Duan N, Farley DO, Greenhalgh T, Haughom JL, Lake E, Lilford R, Lohr KN, Meyer GS, Miller MR, Neuhauser DV, Ryan G, Saint S, Shortell SM, Stevens DP, Walshe K. The top patient safety strategies that can be encouraged for adoption now. Ann Intern Med. 2013;158(5 Pt 2):365–8.

    PubMed  Google Scholar 

  151. Stevens DP, Wagner EH. Transform residency training in chronic illness care – now. Acad Med. 2006;81(8):685–7.

    PubMed  Google Scholar 

  152. Wood KA, Ranji SR, Ide B, Dracup K. Use of rapid response systems in adult academic medical centers. Jt Comm J Qual Patient Saf. 2009;35(9):475–82.

    PubMed Central  PubMed  Google Scholar 

  153. Lannon CM, Miles PV. Pediatric collaborative improvement networks: bridging quality gaps to improve health outcomes. Pediatrics. 2013;131 Suppl 4:S187–8. doi:10.1542/peds.2012-3786D.

    PubMed  Google Scholar 

  154. Baker DP, Salas E, King H, Battles J, Barach P. The role of teamwork in the professional education of physicians: current status and assessment recommendations. Jt Comm J Qual Patient Saf. 2005;31(4):185–202.

    PubMed  Google Scholar 

  155. Davidoff F, Batalden P, Stevens D, Ogrinc G, Mooney SE, SQUIRE Development Group. Publication guidelines for quality improvement studies in health care: evolution of the SQUIRE project. BMJ. 2009;338:a3152.

    PubMed  Google Scholar 

  156. Standards for quality improvement reporting excellence. http://squire-statement.org/. Accessed 10 Mar 2014.

  157. Oermann MH. SQUIRE Guidelines for reporting improvement studies in healthcare: implications for nursing publications. J Nurs Care Qual. 2009;24(2):91–5.

    PubMed  Google Scholar 

  158. Harrington L. Quality improvement, research, and the institutional review board. J Healthc Qual. 2007;29(3):4–9.

    PubMed  Google Scholar 

  159. Ferlie E, Fitzgerald L, Wood M, et al. The nonspread of innovations: the mediating role of professionals. Acad Manage J. 2005;48(1):117–34.

    Google Scholar 

  160. Vohra P, Daugherty C, Mohr J, Wen M, Barach P. Housestaff and medical student attitudes towards adverse medical events. JCAHO Journal of Quality and Safety. 2007;33:467–76.

    Google Scholar 

  161. Porter ME. Defining and introducing value in health care. In: Evidence-based medicine and the changing nature of health care: 2007 IOM annual meeting summary. Washington, DC: Institute of Medicine; 2008. p. 161–72.

    Google Scholar 

  162. Institute for Healthcare Improvement. Triple aim: the best care for the whole population at the lowest cost. http://www.ihi.org/offerings/Initiatives/TripleAim/Pages/default.aspx. Accessed 10 Mar 2014.

  163. Anderson GF, Squires DA. Measuring the U.S. health care system: a cross-national comparison. Issue Brief (Commonw Fund). 2010;90:1–10.

    Google Scholar 

  164. The National Association of County and City Health Officials. A strategic approach to community health improvement: MAPP field guide. National Association of City and County Health Officials; City of publication is Washington, DC. 2007.

    Google Scholar 

  165. Chin MH, Chien AT. Reducing racial and ethnic disparities in health care: an integral part of quality improvement scholarship. Qual Saf Health Care. 2006;15:79–80.

    CAS  PubMed Central  PubMed  Google Scholar 

  166. Weiss KB, Wagner R, Nasca TJ. Development, testing, and implementation of the ACGME Clinical Learning Environment Review (CLER) program. J Grad Med Educ. 2012;4(3):396–8.

    PubMed Central  PubMed  Google Scholar 

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Philibert, I., Miles, P.V. (2015). Professional Formation of Physicians Focused on Improving Care. In: Barach, P., Jacobs, J., Lipshultz, S., Laussen, P. (eds) Pediatric and Congenital Cardiac Care. Springer, London. https://doi.org/10.1007/978-1-4471-6566-8_7

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