Quality Improvement

THE MICHIGAN INSTITUTE FOR QUALITY IMPROVEMENT, PATIENT SAFETY & HIGH VALUE CARE

SEMCME Quality Improvement Programs

The 2021 ACGME Report on the Clinical Learning Environment Review emphasizes the “need to engage residents and fellows to ensure optimal implementation and sustainability of patient care improvement that is most proximate to the patient experience”. Additionally, section VI of the ACGME Common Program Requirements emphasize that all physicians share responsibility for promoting patient safety and enhancing quality of patient care. As a result, graduate medical education training programs must prepare residents to provide clinical care with continuous focus on the safety, individual needs, and humanity of their patients.

The programs described below are intended to:

·       Help identify and unite QI scholars across SEMCME member institutions in order to promote the widespread practice of continuous quality improvement among trainees of SEMCME member institutions

·       Address the 2021 CLER findings that “generally clinical learning environments do not engage all their residents and fellows in their organization’s efforts to design, evaluate, and improve patient safety and health care quality”.  SEMCME addresses this by providing training to faculty, fellows, and residents to help improve their skills and knowledge in the practice of QI

·       Promote competency-based approaches in quality improvement and patient safety

·       Support scholars in QI

 

I.              BOOTCAMP COURSE #1:  FUNDAMENTALS OF QUALITY IMPROVEMENT

Four-hour course designed to introduce the basic concepts of quality improvement to residents beginning their first projects.  The course covers a number of concepts about Quality Improvement:

·           Differences between Quality Improvement and Clinical Research

·           Why we need to learn quality improvement

·           System-based thinking

·           How to set up a QI project

In addition, the course provides an overview of the basic tools and approaches used in the conduct of QI projects:

·           Lean, 6 Sigma, 7 Steps

·           Setting an AIM statement

·           Measurement and understanding data variation

·           Identifying root causes

·           Using Process Maps

·           Cause and Effect

An overview is provided of the Collaborative Quality Initiatives (CQI) that exist in the state of Michigan that are sponsored by Blue Cross Blue Shield of Michigan and information is shared on opportunities that residents have to participate in evaluation of CQI data.

 

II.            BOOTCAMP COURSE #2:  APPLIED QUALITY IMPROVEMENT FOR PROGRAM DIRECTORS, FACULTY AND FELLOWS

Two part workshop that is designed to help program directors and faculty guide residents and fellows in their QI projects.  Course incorporates more in-depth and advanced quality improvement concepts and includes access to materials that can be used to structure and implement QI projects.  Course offers 8 CME credits.

 Course Objectives:

Teach faculty to guide residents to perform QI projects as scholarly activity using IHI Model for Improvement & the Seven Steps Method

·           Assist faculty in teaching residents to use QI tools on an excel-based add-on program

·           Describe how to apply flowchart and mind map using a web-based program

·           Guide Residents to align QI projects with institutional goals and priorities using a logic model

This “train-the-trainer” course covers:

·           Review of IHI Model for Improvement, 7 Steps, 7 Tools, and QI Macro

·           IHI QI Essentials Template

·           Directing Residents and Fellows on their QI projects

·           The Ethics of Using Quality Improvement Methods in Health Care

·           Concept of High Value Care

 

III.         MICHIGAN SUMMIT ON QUALITY IMPROVEMENT, PATIENT SAFETY & HIGH VALUE CARE

Annual conference that brings together nearly 300 faculty, fellows and residents to present the results of QI projects from across the state of Michigan.  Program includes voice-over power point presentations of QI projects from Michigan residents and fellows, livestream presentations of top projects, along with a nationally recognized keynote speaker. Monetary prizes are awarded for the top projects.  The Michigan Summit on Quality Improvement, Patient Safety & High Value Care is designed to focus on the initial steps of quality improvement by highlighting the importance of residents and fellows in the process of identifying areas of improvement. This Summit further aids health care systems by providing the tools to effectively study the targeted areas of improvement.

 

IV.         QUALITY IMPROVEMENT SCHOLARS PROGRAM

To prepare physicians in the organization, implementation, and analysis of quality improvement and patient safety initiatives, SEMCME is currently developing a program intended to provide physicians with the knowledge, skills, and tools necessary for designing and implementing quality improvement projects.  Through the program, trainees will have an opportunity to showcase their work with the ultimate goal of disseminating lessons learned to a broader audience of clinicians.

1)         Quality Improvement boot camp courses

Bootcamp on Fundamentals of QI (as described previously)

Quality Improvement for Program Directors, Faculty, and Fellows (as described previously)

Advanced QI Bootcamp for those that have successfully completed the first two boot camp courses and have completed a QI project with at least one PDSA cycle.

 

2)         QI Scholars Program

Students who complete the Fundamentals of QI Bootcamp course will be eligible to apply to become a “QI Scholar” which will provide a mentored longitudinal QI project.  Trainees will be paired with two faculty mentors, one from their own institution and a second from another institution, to guide and facilitate their QI project.  The intent is that that these QI scholars will participate in the advanced QI courses and will continue their QI studies to ultimately be qualified to become board certified in QI through the American Board of Medical Quality or the Health Care Quality and Patient Safety Certification through:

·           American College of Medical Quality,

·           The American Board of Quality Assurance and Utilization Review Physicians (ABQAURP),

·           National Association for Healthcare Quality (NAHQ), or

·           American Society for Quality (ASQ).

SEMCME is in active development of this program and is piloting the program with their first QI Scholar in the winter/spring of 2022.

 

V.           QUALITY IMPROVEMENT DOCUMENT LIBRARY

The purpose of the QI library is to create a clearinghouse for resources, tools, and best practices on Quality Improvement that is accessible for all SEMCME members.  In collaboration with the Metropolitan Detroit Medical Library Group (MDMLG), SEMCME is gathering resources that can be used by students, faculty, and Quality Improvement Scholars in training, conduct of projects, and in research related to quality improvement, patient safety, and high value care.

 

Currently, SEMCME staff have assembled numerous documents, videos, courses, tools  and other QI materials on the SEMCME Website.  These materials will be reviewed by librarians to evaluate appropriate organization, cataloguing, and copyright permissions to create a library that is accessible to SEMCME members.

 

The intent is to obtain permission from SEMCME member institutions to link to their quality improvement materials, thus broadly expanding the breadth and accessibility of materials.  SEMCME is working with the medical librarians to ensure compliance with copyright laws and the Fair Use Act.  SEMCME is also working to determine how site security will be maintained, while providing maximum accessibility to members.