Integrating Quality and Education Defining and creating educational interventions to improve health, healthcare and innovation.

Integrating Quality and Education

Defining and creating educational interventions to improve health, healthcare and innovation

Why Quality Improvement and Education? 1) The patient’s perspective

The clinical care gap

2) The National view:Dartmouth Atlas 2010 - HbA1c data

3) The Reports (among them, Teaching for Quality,

2013)

The Te4Q Vision:Quality Improvement is core to what it means to be a physician

A Recommendation:“Every academic health center will have a critical mass of faculty ready, able and willing to engage in, role model, and teach about patient safety and the improvement of health care”

AAMC’s Educational Response- an outgrowth of the Integrating Quality initiative

Aligning and Educating for Quality (ae4Q)

A consultative service focused on organizational and educational methods to improve quality

Initiated 2012

Teaching for Quality (Te4Q)

A faculty development initiative Initiated 2014

ae4Q: aligning and educating for quality

• An educational process• Use of quality metrics in planning and assessment• Use of evidence based interventions (including HIT, team

training, staff development)

• A suggested organizational alignment of CME and GME, QI/PI initiatives, practice plans, electronic health records, faculty/staff development, credentials…

• On-line Resources, Community of Practice

ae4Q sites, Feb, ‘15

Two examples of ae4Q initiatives

Quality Rounds•Apply quality metrics to planning process•Convert quality gaps into learning objectives•Develop effective, interactive educational rounds; or series of rounds•May repeat theme or gap•Evaluate outcomes

M&M Conferences – MM&I•Use systems-based approach•Review several or more cases, de-emphasizing single case•Explore causal factors•Explore and refine improvement efforts•Report at subsequent rounds

Some achievements…..

• AMC outcomes • Patient care, process & educational

improvements*• Re-alignment of CME with other

entities; clinical/ CME committee representation

• Champions, recognition of value of CME

• Organizational MOC• ? cost savings• ? imbedding QI/PS into the culture

of an institution• Others…

• Our joint products• Markers of organizational

readiness: alignment, educational effectiveness, champions, drivers and barriers

• Resources to facilitate the integration

• Sharing of Best Practices; Communities of Practice

• Dissemination of results; publications; presentations

Davis, N et al, Acad Med, 2013

Pingleton S et al, Acad Med, 2013

The Te4Q engagement

• Pre-Requisite: some knowledge of QI/PS• Self- & Organizational-Readiness Assessments• Pre-reading• Skill Building Workshop• Extensive workbook covering principles of effective teaching, learning,

curricular design and assessment• QI Educational Project w/presentation in 3 mo.• Community of Practice• Dissemination of Work—Presentation or Publication• Certificate

Te4Q Sites 2013-2014 (Phase 1)

Northeast Region Workshops held

Geisinger Health System* April 2014

Jefferson School of Population Health November 2014

(affiliated with The Sidney Kimmel Medical College at Thomas Jefferson University)

North Shore Long Island Jewish Health System September 2014

Stony Brook University School of Medicine December 2014

University of Rochester School of Medicine and Dentistry October 2014

Southern Region

Marshall University Joan C. Edwards School of Medicine August 2014

University of Mississippi Medical Center August 2014

Central Region

Case Western Reserve University School of Medicine* February 2014

Providence Hospital and Medical Center May 2014

(affiliated with St. Johns Health System)

University of Kansas Medical Center ** September 2013

University of Michigan Medical School October 2014

University of Minnesota Medical School* September 2014

Western Region

University of California, San Francisco School of Medicine January 2015

*Te4Q Partner Sites **Te4Q Pilot

• ~30 participants per site

• Total of >400 participants to date, including pilot site

• Roughly 300 projects, for example:• Full curricular reform (UME, GME, faculty development)• Development of experiential learning for students, residents• Targeted interventions to improve sepsis, VTE management,

readmissions• Reformatting M&M conferences into systems-based experiences

• Dozens of Project Review Events completed (roughly 100 participant projects reviewed)

• Six certificates delivered

Participant tracking: 2013-2014

2015 Confirmed Te4Q Sites (Phase 2*)

1. The Warren Alpert Medical School of Brown University

2. Duke University

3. Michigan State College of Osteopathic Medicine

4. University of New Mexico School of Medicine

5. University of Vermont College of Medicine

6. VA Nebraska – Western Iowa Health System

7. In the pipeline: Temple University

University of Florida College of Medicine

University of South Alabama

plus others*Phase 2: more site engagement pre and post workshop; increased tailored experience to meet system and educational program needs; workbook

www.aamc.org/ae4Q www.aamc.org/te4Q

Integrating Quality Annual Meeting (IQ)

• Chicago O’Hare• June 11-12 2015• Combination of keynote presentations, workshops, posters, many

featuring resident projects and training programs

• Post-IQ workshop (June 23-13): regulatory and accreditation changes affecting GME and quality, focused on DIOs, program directors, others interested in residency education and faculty development

www.aamc.org/meetings