Background: Identifying system failures and contributing to a culture of safety and improvement has been recognized by the AAMC as a Core Entrustable Professional Activity (EPA) for entering residency. The AAMC has endorsed increased quality improvement and patient safety (QI/PS) education during medical school. However, a cross-sectional study found that medical students have low knowledge of patient safety and quality improvement. Therefore, providing only fundamental knowledge of QI/PS without application may not be enough to provide entrustment.
Purpose: The Health Systems, Informatics and Quality Improvement (HSIQ) Curriculum at our institution aims to provide competency in providing safe, timely, effective, efficient, equitable and patient-centered care as defined by the Institute of Medicine. This curriculum also aims to provide entrustment of EPA 13.
Description: During the four year integrated curriculum (HSIQ), students receive fundamental knowledge through completion of the Institute for Healthcare Improvement’s open school modules. During the third year, students work with safety coaches to develop DMAIC methodology, complete the steps of a MOC improvement project and see QI underway within the clinical settings. Finally, during their senior year, all students complete a DMAIC-based project in teams with a faculty mentor. Projects are chosen related to areas of system failures they have identified during their clinical years. Not surprisingly, medical students identify many ongoing problems of which both the internal medicine and pediatric hospitalists are already focusing on through QI work. By pairing these medical student teams with a hospitalist mentor, the hospitalist gains new ideas and approaches to their project and the students learn the process of QI. For the 2018 class, examples of hospital medicine and pediatrics projects include: Improving patient satisfaction through the use of photo cards, adherence to quiet at night protocols, improving frequency of physician-nurse bedside rounding, increasing hand washing, reducing length of stay through decreasing unnecessary inpatient echocardiograms and MRIs, improving handovers by improved medication discharge documentation, increasing the use of therapy dogs for pediatric crisis patients and improving resource utilization throughout promotion of clinically indicated lab ordering practices.
Conclusions: The Health Systems, Informatics and Quality Improvement (HSIQ) Curriculum provides the ability to entrust that students are able to identify a system failure and contribute to a culture of safety and improvement. Entrustment is achieved through completion of a quality improvement project using DMAIC methodology on problems they identified throughout their clinical years. In addition, HSIQ allows for further innovative approaches to problems already being addressed by hospitalists through a bottom up approach. We look forward to the results of these projects which will be presented in early March of 2018.
To cite this abstract:Heacock, A; Tartaglia, K; Kman, N; Duncan, P; Gonsenhauser, I. HEALTH SYSTEMS, INFORMATICS AND QUALITY IMRPOVEMENT CURRICULUM PROVIDES FRESH IDEAS TO HOSPITAL MEDICINE QI PROJECTS. Abstract published at Hospital Medicine 2018; April 8-11; Orlando, Fla. Abstract 61. https://www.shmabstracts.com/abstract/health-systems-informatics-and-quality-imrpovement-curriculum-provides-fresh-ideas-to-hospital-medicine-qi-projects/. Accessed April 1, 2020.