Recognition of poor value in US healthcare is leading to reform of the hospital payment system. Effective physician leadership will be crucial for the potential gains from aligning incentives to be translated into improved value. Despite the central role physician’s play, traditional residency training neglects essential skills that physician leaders need in the new healthcare environment.
In response to these demands, we developed a new track within our Internal Medicine Residency Program: The Healthcare Leadership Track (HLT). The track’s purpose is to teach leadership, quality improvement (QI), hospital finance, and teaching skills in the era of healthcare reform. The goal is to provide the necessary knowledge and skills for residents whose primary career venue will be within hospitals to become successful leaders.
Four residents began the track at the start of their PGY2 year in July 2011. The HLT is comprised of didactics and exercises delivered during elective blocks plus longitudinal components spanning the PGY2 and PGY3 years. Each elective block targets a core area: QI and Patient Safety (QI/PS); The Business of Medicine; Teaching and Leadership; and QI Research. Each block begins with didactics on core topics. The foundation of the track is a series of novel structured exercises to develop the newly acquired knowledge and skills using practical applications. The HLT began with the QI/PS block, which is described in detail as an example. Didactic topics include an introduction to QI/PS, rootcause analysis, medical error reporting, risk management, and clinical pathways. Block exercises include leading a transitions module with interns; proposing a new clinical pathway; leading our monthly noon conference on QI; and participation in a Book Club promoting analysis and application of a relevant text. Longitudinal components include a mentored QI research project; pairing with a ward medical director to become engaged in hospital operations, performance, and quality initiatives; and becoming members of the Department’s QI committee. HLT residents are also funded to attend one national meeting to enhance their knowledge and/or present their QI work. Evaluations from the initial block show that on a 5point Likert scale, all the participating residents “strongly agree” they are much more likely to think about and participate in quality and patient safetyrelated activities. In addition, they all reported that they “strongly agree” that the block was highly relevant to their current and future careers.
Teaching quality improvement, leadership skills, and the business of medicine is necessary for physicians to be successful leaders in the hospital of the future. Early experience from the HLT suggests this model can be seamlessly integrated into the IM residency and can help train motivated residents in these proficiencies.
To cite this abstract:Dunn A, Markoff B. Healthcare Leadership Track: A Novel Track to Train Leaders in Inpatient Medicine. Abstract published at Hospital Medicine 2012, April 1-4, San Diego, Calif. Abstract 97757. Journal of Hospital Medicine. 2012; 7 (suppl 2). https://www.shmabstracts.com/abstract/healthcare-leadership-track-a-novel-track-to-train-leaders-in-inpatient-medicine/. Accessed September 18, 2019.