ACGME requires residents training in internal medicine residency programs to be active participants in quality improvement projects. ABIM offers practice improvement modules (PIM) to teach residents QI techniques. In 2008. Baystate Medical Cenler (BMC) internal medicine residency program received the D Duffy ABIM grant to support resident‐driven research evaluating ABIM Hospital PIMs.
To examine the effect of a resident‐driven QI initiative to increase the use of care sets lor HF and pneumonia. We hypothesized that our intervention would increase the rate of care set usage and secondarily improve the rates of condition‐specific composite quality score.
A QI group comprised of residents, hospitalists, and representatives from the Division of Health Care Quality was formed to complete the ABIM PIMs for heart failure (HF) and pneumonia. AT BMC we have mature CPOE care sets for HF and pneumonia. Despite strong evidence that they improve physicians' adherence lo guidelines and patients outcomes, historically they have been underutilized in our institution. The residents decided to focus on improving the utilization of care sets among residents and hospitalists. We used data collected by the Division of Health Care Quality, which reflects the rate of care set utilization and the HF and pneumonia composite quality scores from October 2008 to October 2009. To increase Ihe utilization of CPOE care sets, we developed a multifaceted educational program for health care providers. We had monthly noon conferences for the residents and hospitalists, where we presented the evidence behind the orders in the care sets, discussed the barriers lo utilization and conducted a survey lo determine attitudes toward care set utilization. Using PIMs data, the group performed multiple small tests of change by Ihe PDSA cycle lo increase care set usage. Multiple changes were made to the CPOE care sets per recommendations and suggestions of the residenls and hospitalists, makinc them more user friendly and accessible. HF CPOE care sets usage increased from 30% lo 58%, and HF composite score for same period also increased from 93% to 98.2%. For pneumonia, the care set utilization improved from 50% to 65% and the composite score from 81% to 88%.
We used ABIM PIMs as a stimulus for practical application of QI concepts and methods within an internal medicine residency program. We were able lo create a faculty/resident inpatient QI group, which identified gaps in quality of care and implemented successful interventions. For many residents, this group provided a unique opportunity to learn and participate in QI activities and procedures. Engaging residents in Ql projects not only improved their knowledge of QI initiatives, but also directly affected BMC CPOE care set utilization and hospital quality scores for HF and pneumonia. Quality improvement education needs to be a formalized part of residents' education.
M. Stefan, Baystate Medical Center employment; R. Belforti, Baystate Medical Center, employment: M. Jankowske, Baystate Medical Center, employment; S, Workman, Baystate Medical Center, employment; G. Coady, Baystate Medical Center, employment; M, Kelly, Bay‐state Medical Center, employment; A. Bhargava, Baystate Medical Center, employment; M. Shingh, Baystate Medical Center, employment; M. Se‐kiguchi, Baystate Medical Center, employment; J. Hernandez, Baystate Medical Center, employment.
To cite this abstract:Stefan M, Belforti R, Jankowske M, Workman S, Coady G, Kelly M, Bhargava A, Hernandez J, Sekiguchi M, Seller A, Boon O, Singh M, Bhagavan A, Madera F, Fitzgerald J, Yadav S. Using ABIM Performance Improvement Modules to Improve Care Set Utilization and Quality‐Care Indicators and to Enhance Resident Education in Quality Improvement. Abstract published at Hospital Medicine 2010, April 8-11, Washington, D.C. Abstract 197. Journal of Hospital Medicine. 2010; 5 (suppl 1). https://www.shmabstracts.com/abstract/using-abim-performance-improvement-modules-to-improve-care-set-utilization-and-qualitycare-indicators-and-to-enhance-resident-education-in-quality-improvement/. Accessed May 23, 2019.