Creating a quality improvement elective for medical house officers
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The Accreditation Council on Graduate Medical Education (ACGME) requires that house officers demonstrate competencies in “practice-based learning and improvement” and in “the ability to effectively call on system resources to provide care that is of optimum value.” Anticipating this requirement, faculty at a Boston teaching hospital developed a 3-week elective for medical house officers in quality improvement (QI).
The objectives of the elective were to enhance residents’ understanding of QI concepts, their familiarity with the hospital’s QI infrastructure, and to gain practical experience with root-cause analysis and QI initiatives. Learners participated in three didactic seminars, joined hospital-based QI activities, conducted a root-cause analysis, and completed a QI project under the guidance of a faculty mentor.
The elective enrolled 26 residents in 3 years. Sixty-three percent of resident respondents said that the elective increased their understanding of QI in health care; 88% better understood QI in their own institution.
- President’s Advisory Commission on Consumer Protection and Quality in the Health Care Industry. Quality First: Better Health Care for All Americans. Washington, DC: USGPO, 1998.
- Kohn LT, Corrigan JM, Donaldson MS, eds. To Err Is Human: Building a Safer Health System. Washington, DC: National Academy Press; 1999.
- Committee on the Quality of Healthcare in America. Crossing the Quality Chasm: A New Health System for the 21st Century. Washington, DC: National Academy Press; 2001.
- Council on Graduate Medical Education: Managed Health Care: Implications for the Physician Workforce and Medical Education (6th report). Washington, DC: U.S. Department of Health and Human Services; 1995.
- Pew Health Professions Commission: Health Professions Education and Managed Care: Challenges and Necessary Responses. San Francisco, Calif: University of California, San Francisco; 1995.
- ACGME Outcome Project. Available at: http://www.acgme.org/outcome/comp/compFull.asp. Accessed May 24, 2004.
- Weingart SN. Making medication safety a strategic organizational priority. Jt Comm J Qual Improv. 2000;26:341–8.
- Ashton CM. “Invisible” doctors: making a case for involving medical residents in hospital quality improvement programs. Acad Med. 1993;68:823–4. CrossRef
- Headrick LA, Kathcher W, Neuhauser D, McEachern E. Continuous quality improvement and knowledge for improvement applied to asthma care. Jt Com J Qual Improv. 1994;20:562–8.
- Headrick LA, Neuhauser D, Melnikow J, Vanek E. Teaching medical students about quality and cost of care at Case Western Reserve University. Acad Med. 1992;67:157–9. CrossRef
- Headrick L, Neuhauser D, Melnikow J. Asthma health status: ongoing measurement in the context of continuous quality improvement. Med Care. 1993;31(3 suppl):MS97-MS105.
- Gordon PR, Carlson L, Chessman A, Kundrat ML, Morahan PS, Headrick LA. A multisite collaborative for the development of interdisciplinary education in continuous improvement for health professions students. Acad Med. 1996;71:973–8. CrossRef
- Headrick LA, Knapp M, Neuhauser D, et al. Working from upstream to improve healthcare: the IHI interdisciplinary professional education collaborative. Jt Com J Qual Improv. 1996;22:149–64.
- Alexander GC, Fera B, Ellis R. From the students: learning continuous improvement by doing it. Jt Com J Qual Improv. 1996;22:198–205.
- Headrick LA, Richardson A, Priebe GP. Continuous improvement learning for residents. Pediatrics. 1998;101:768–74.
- Parenti CM, Lederle FA, Impola CL, Peterson LR. Reduction of unnecessary intravenous catheter use: internal medicine house officers participate in a successful quality improvement project. Arch Intern Med. 1994;154:1829–32. CrossRef
- Welsh CH, Pedot R, Anderson RJ. Use of morning report to enhance adverse event detection. J Gen Intern Med. 1996;11:454–60. CrossRef
- Ellrodt AG. Introduction of total quality management (TQM) into an internal medicine residency. Acad Med. 1993;68:817–23. CrossRef
- Weingart SN. A medical house officer-sponsored quality improvement initiative: leadership lessons and liabilities. Jt Comm J Qual Improv. 1998;24:371–8.
- Curley C, McEachern JE, Speroff T. A firm trial of interdisciplinary rounds on the inpatient medical wards: an intervention designed using continuous quality improvement. Med Care. 1998;26:AS4–12. CrossRef
- Rosebraugh CJ, Honig PK, Yasuda SU, Pezzullo JC, Woosley RL. Centers for Education and Research on Therapeutics report: survey of medication error education during undergraduate and graduate medical education in the United States. Clin Pharmacol Ther 2002;71:4–10. CrossRef
- Gosbee JW. Human factors engineering is the basis for a practical error-in-medicine curriculum. In: Johnson C, ed. Glasgow Accident Analysis Group Technical Report G99-1. Glasgow, Scotland: University of Glasgow; 1999.
- Holmboe E, Scranton R, Sumption K, Hawkins R. Effect of medical record audit and feedback on resident’s compliance, with preventive health care guidelines. Acad Med. 1998;73:901–3. CrossRef
- Gunther GS, Bingham RL. A continuous quality improvement cycle for teaching the identification of psychosocial problems to general internal medicine residents. Acad Med. 1993;67:308–10. CrossRef
- Sox CM, Burstin HR, Orav J, et al. The effect of supervision of residents on quality of care in five university-affiliated emergency departments. Acad Med. 1998;73:776–82. CrossRef
- Leshan LA, Fitzsimmons M, Marbella A, Gottlieb M. Increasing clinical prevention efforts in family practice residency program through CQI methods. Jt Comm J Qual Improv. 1997;23:391–400.
- Creating a quality improvement elective for medical house officers
Journal of General Internal Medicine
Volume 19, Issue 8 , pp 861-867
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- quality improvement
- patient safety
- interns and residents
- medical education
- Industry Sectors
- Author Affiliations
- 1. Received from the Department of Medicine, Stoneman Center for Quality Improvement in General Medicine and Primary Care, USA
- 2. Harvard Medical School, Boston, Mass
- 4. Department of Healthcare Quality, Beth Israel Deaconess Medical Center, USA