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.
quality improvement patient safety interns and residents medical education
This is a preview of subscription content, log in to check access.
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.Google Scholar
Kohn LT, Corrigan JM, Donaldson MS, eds. To Err Is Human: Building a Safer Health System. Washington, DC: National Academy Press; 1999.Google Scholar
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.Google Scholar
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.Google Scholar
Pew Health Professions Commission: Health Professions Education and Managed Care: Challenges and Necessary Responses. San Francisco, Calif: University of California, San Francisco; 1995.Google Scholar
ACGME Outcome Project. Available at: http://www.acgme.org/outcome/comp/compFull.asp. Accessed May 24, 2004.Google Scholar
Weingart SN. Making medication safety a strategic organizational priority. Jt Comm J Qual Improv. 2000;26:341–8.PubMedGoogle Scholar
Ashton CM. “Invisible” doctors: making a case for involving medical residents in hospital quality improvement programs. Acad Med. 1993;68:823–4.PubMedCrossRefGoogle Scholar
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.Google Scholar
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.PubMedCrossRefGoogle Scholar
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.PubMedGoogle Scholar
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.PubMedCrossRefGoogle Scholar
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.Google Scholar
Alexander GC, Fera B, Ellis R. From the students: learning continuous improvement by doing it. Jt Com J Qual Improv. 1996;22:198–205.Google Scholar
Headrick LA, Richardson A, Priebe GP. Continuous improvement learning for residents. Pediatrics. 1998;101:768–74.PubMedGoogle Scholar
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.PubMedCrossRefGoogle Scholar
Welsh CH, Pedot R, Anderson RJ. Use of morning report to enhance adverse event detection. J Gen Intern Med. 1996;11:454–60.PubMedCrossRefGoogle Scholar
Ellrodt AG. Introduction of total quality management (TQM) into an internal medicine residency. Acad Med. 1993;68:817–23.PubMedCrossRefGoogle Scholar
Weingart SN. A medical house officer-sponsored quality improvement initiative: leadership lessons and liabilities. Jt Comm J Qual Improv. 1998;24:371–8.PubMedGoogle Scholar
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.CrossRefGoogle Scholar
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.PubMedCrossRefGoogle Scholar
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.Google Scholar
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.PubMedCrossRefGoogle Scholar
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.CrossRefGoogle Scholar
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.PubMedCrossRefGoogle Scholar
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.PubMedGoogle Scholar