Transcript Jo-Inge Myhre, MD and Jessica Perlo, MPH 19th Annual
Slide 1
Open School
19th Annual International Forum on
Quality and Safety in Healthcare
This presenter has nothing to disclose
D4: Bridging the gap
between undergraduate
and postgraduate education
Jo-Inge Myhre, MD and Jessica Perlo, MPH
April 10, 2014
Slide 2
Meet Dan
Slide 3
3
Took Courses & Created a Chapter
IHI Open School
working group
Motivated and
passionate
volunteers
Weekly meetings
Slide 4
Leveraged Faculty
Partnership with institutional
leadership, secured a mandate
Georgetown Center for Patient Safety
Georgetown Masters in Health System
Administration
Georgetown School of Medicine
- Remove barriers
- Buy faculty time
- Encourage learners to participate
Slide 5
Recruited Interprofessional Members
Slide 6
6
Focused on Institutional Priorities
Engaged students/trainees in projects that were central
to the strategic plan of their health care organization
For them, this meant:
– Resident handoffs
– Central line blood stream infections
– Hospital readmissions
– DVT prophylaxis improvement
– Post discharge communication with community primary care
physicians
– Hand hygiene
– Central line air embolism prevention
– Private partnership with an industry partner
Slide 7
Built the Case for Resident
Involvement
System dysfunction is never more evident than when
one is in training.
– Because of the unfortunate nature of our training system,
trainees are often blamed for system errors
Because of this front line view, there is a tremendous will
for change among trainees.
They are tremendously agile in their thought processes
and are not attached to an ingrained status quo.
They rarely have the opportunity to work in an
interprofessional manner.
Slide 8
Practicum example: CLABSI
Team structure:
– Health system administration student: project manager, Daniel
–
–
–
–
Bitman, BS
Physician champion: medicine resident, Daniel Alyeshmerni, MD
Nursing champion: Elizabeth Giunta, RN
Medical student: Orlando Sabbag, MSIII Peter Aleksandrov, MSIII
Nursing student: Lindsay Gingras
Barriers: time, focus,
maintaining momentum
Results:
– On vascular surgery unit, CLABSI rate
~ 3.2/1000 device days to 0 CLABSI
rate for over one year
Slide 9
Continued Professional Growth
Presented work at
conferences
Quality Improvement
Chief Resident, DC VA
VA Quality Scholar
Fellowship
IHI Improvement
Advisor Training
Cardiology Fellowship,
UMI
Faculty Advisor to UMI
Chapter
Slide 10
Slide 11
Dan’s Experience
(Beginning
Prelicensure
Learner)
(Advanced
Prelicensure
Learner)
(Beginning
Postlicensure
Learner)
(Advanced
Postlicensure
Learner)
Competent
Proficient
Novice
Advanced
Beginner
Expert
Student
OS Courses
Resident/
Trainee/
Junior
Doctor
OS Practicum
Faculty
IHI IA, VA Quality Scholar
QI Educator
* Adapted from Ogrinc G, et al. A framework for teaching medical students and residents about
practice-based learning and improvement. Acad Med. 2003; 78(7): 748-756
Slide 12
Actual State
(Beginning
Prelicensure
Learner)
(Advanced
Prelicensure
Learner)
(Beginning
Postlicensure
Learner)
(Advanced
Postlicensure
Learner)
Novice
Advanced
Beginner
Competent
Proficient
Expert
Student
OS Courses
Resident/
Trainee/
Junior
Doctor
OS Courses
Faculty
OS Courses
QI Educator
* Adapted from Ogrinc G, et al. A framework for teaching medical students and residents about
practice-based learning and improvement. Acad Med. 2003; 78(7): 748-756
Slide 13
Early Postlicensure Barriers
Junior Doctor/Residents’ busy schedules
Not enough mentors who feel comfortable providing
guidance
Lack of interest among trainees or belief that QI/PS is
unimportant
Trainees’ transient presence on certain units or rotations
Lack of time to teach basic foundational principles of
quality and safety
Lack of infrastructure (data managers, statisticians)
Lack of support from residency leadership regarding
perceived value of these activities
Slide 14
Graduate Training Success Factors
1. Health system culture embraces the idea that residents
2.
3.
4.
5.
and junior doctors are critical to quality and safety.
Engaged, capable faculty are willing to mentor.
Training projects are aligned with quality and safety
institutional goals.
Early student exposure to QI concepts can create
champions and a pathway for application once they
enter the delivery system
Ongoing, experiential learning opportunities allow deep
practice.
Slide 15
IHI Open School Mission
“Advance health care improvement and patient safety
competencies in the next generation of health
professionals worldwide.”
Slide 16
The IHI Open School
Curriculum
Content
Community
Networks
Experiential
Learning
Slide 17
IHI Open School Courses
• 23 online courses developed by world-renowned
experts in the following topics:
• Improvement Capability
• Patient Safety
• Person- and Family-Centered Care
• Triple Aim for Populations
• Quality, Cost, and Value
• Leadership
• Mobile App for iPhone and iPad
Slide 18
Certificates
Certificate of
Completion
30 contact hours
available for nurses,
physicians, and
pharmacists
Slide 19
Community
Physician
Assistant
200,000+ students,
residents, and
professionals
638 Chapters in 67
countries
167 Chapters (26%)
are located in
hospitals or health
systems
Pharmacy
Social Work
Allied
Health
Professions
Business
Occupation
al &
Physical
Therapy
Dentistry
Engineering
Nursing
Medicine
Law
Health
Science &
Administrat
ion
Slide 20
Quality Improvement Practicum (QI201)
Learner-driven quality improvement projects
Within local clinical setting
Opportunity to apply gained knowledge
Project Examples:
– Reducing wait times
– Improving hand hygiene compliance rates
– Improving medication processes and implement
checklists
Slide 21
Combining QI&PS with
Leadership Training and EBM
Jo Inge Myhre, MD
Teaching assistant ”KLoK”
University of Oslo Medical School
Slide 22
Aim of KLoK
Through KLoK you’ll aquire knowledge and skills in
EBM, leadership and quality improvement. This will aid
you in your future professional role as an individual as
well as a member/leader of teams.
Slide 23
Course overview
1. sem.: Introduction to patient safety (lecture)
6. sem.: Leadership and patient safety (seminar)
7. sem.: One week course in EBM (with exam)
10. sem.: EBM, Leadership and QI, Lectures, seminars and individual
assignments during rotations in both hospitals and primary care
–
–
–
Critical analysis of scientific publication and or guideline
Patient satisfaction
”The patient’s journey”
11. semester:
–
–
Lectures and seminars
Group based assignment (QI Project proposal)
12. semester:
–
–
–
”Survival week”
Student-BEST – Interprofessional simulation day
OSCE
Slide 24
Our experience
It’s hard to teach one subject without the others
Making it as clinical as possible is crucial
Invite students in the process
Create mechanism for continuous evaluation of the
course
Slide 25
QUESTIONS?
Email [email protected]
Like us on Facebook
Follow us on Twitter
@IHIOpenSchool
Download our App
Open School
19th Annual International Forum on
Quality and Safety in Healthcare
This presenter has nothing to disclose
D4: Bridging the gap
between undergraduate
and postgraduate education
Jo-Inge Myhre, MD and Jessica Perlo, MPH
April 10, 2014
Slide 2
Meet Dan
Slide 3
3
Took Courses & Created a Chapter
IHI Open School
working group
Motivated and
passionate
volunteers
Weekly meetings
Slide 4
Leveraged Faculty
Partnership with institutional
leadership, secured a mandate
Georgetown Center for Patient Safety
Georgetown Masters in Health System
Administration
Georgetown School of Medicine
- Remove barriers
- Buy faculty time
- Encourage learners to participate
Slide 5
Recruited Interprofessional Members
Slide 6
6
Focused on Institutional Priorities
Engaged students/trainees in projects that were central
to the strategic plan of their health care organization
For them, this meant:
– Resident handoffs
– Central line blood stream infections
– Hospital readmissions
– DVT prophylaxis improvement
– Post discharge communication with community primary care
physicians
– Hand hygiene
– Central line air embolism prevention
– Private partnership with an industry partner
Slide 7
Built the Case for Resident
Involvement
System dysfunction is never more evident than when
one is in training.
– Because of the unfortunate nature of our training system,
trainees are often blamed for system errors
Because of this front line view, there is a tremendous will
for change among trainees.
They are tremendously agile in their thought processes
and are not attached to an ingrained status quo.
They rarely have the opportunity to work in an
interprofessional manner.
Slide 8
Practicum example: CLABSI
Team structure:
– Health system administration student: project manager, Daniel
–
–
–
–
Bitman, BS
Physician champion: medicine resident, Daniel Alyeshmerni, MD
Nursing champion: Elizabeth Giunta, RN
Medical student: Orlando Sabbag, MSIII Peter Aleksandrov, MSIII
Nursing student: Lindsay Gingras
Barriers: time, focus,
maintaining momentum
Results:
– On vascular surgery unit, CLABSI rate
~ 3.2/1000 device days to 0 CLABSI
rate for over one year
Slide 9
Continued Professional Growth
Presented work at
conferences
Quality Improvement
Chief Resident, DC VA
VA Quality Scholar
Fellowship
IHI Improvement
Advisor Training
Cardiology Fellowship,
UMI
Faculty Advisor to UMI
Chapter
Slide 10
Slide 11
Dan’s Experience
(Beginning
Prelicensure
Learner)
(Advanced
Prelicensure
Learner)
(Beginning
Postlicensure
Learner)
(Advanced
Postlicensure
Learner)
Competent
Proficient
Novice
Advanced
Beginner
Expert
Student
OS Courses
Resident/
Trainee/
Junior
Doctor
OS Practicum
Faculty
IHI IA, VA Quality Scholar
QI Educator
* Adapted from Ogrinc G, et al. A framework for teaching medical students and residents about
practice-based learning and improvement. Acad Med. 2003; 78(7): 748-756
Slide 12
Actual State
(Beginning
Prelicensure
Learner)
(Advanced
Prelicensure
Learner)
(Beginning
Postlicensure
Learner)
(Advanced
Postlicensure
Learner)
Novice
Advanced
Beginner
Competent
Proficient
Expert
Student
OS Courses
Resident/
Trainee/
Junior
Doctor
OS Courses
Faculty
OS Courses
QI Educator
* Adapted from Ogrinc G, et al. A framework for teaching medical students and residents about
practice-based learning and improvement. Acad Med. 2003; 78(7): 748-756
Slide 13
Early Postlicensure Barriers
Junior Doctor/Residents’ busy schedules
Not enough mentors who feel comfortable providing
guidance
Lack of interest among trainees or belief that QI/PS is
unimportant
Trainees’ transient presence on certain units or rotations
Lack of time to teach basic foundational principles of
quality and safety
Lack of infrastructure (data managers, statisticians)
Lack of support from residency leadership regarding
perceived value of these activities
Slide 14
Graduate Training Success Factors
1. Health system culture embraces the idea that residents
2.
3.
4.
5.
and junior doctors are critical to quality and safety.
Engaged, capable faculty are willing to mentor.
Training projects are aligned with quality and safety
institutional goals.
Early student exposure to QI concepts can create
champions and a pathway for application once they
enter the delivery system
Ongoing, experiential learning opportunities allow deep
practice.
Slide 15
IHI Open School Mission
“Advance health care improvement and patient safety
competencies in the next generation of health
professionals worldwide.”
Slide 16
The IHI Open School
Curriculum
Content
Community
Networks
Experiential
Learning
Slide 17
IHI Open School Courses
• 23 online courses developed by world-renowned
experts in the following topics:
• Improvement Capability
• Patient Safety
• Person- and Family-Centered Care
• Triple Aim for Populations
• Quality, Cost, and Value
• Leadership
• Mobile App for iPhone and iPad
Slide 18
Certificates
Certificate of
Completion
30 contact hours
available for nurses,
physicians, and
pharmacists
Slide 19
Community
Physician
Assistant
200,000+ students,
residents, and
professionals
638 Chapters in 67
countries
167 Chapters (26%)
are located in
hospitals or health
systems
Pharmacy
Social Work
Allied
Health
Professions
Business
Occupation
al &
Physical
Therapy
Dentistry
Engineering
Nursing
Medicine
Law
Health
Science &
Administrat
ion
Slide 20
Quality Improvement Practicum (QI201)
Learner-driven quality improvement projects
Within local clinical setting
Opportunity to apply gained knowledge
Project Examples:
– Reducing wait times
– Improving hand hygiene compliance rates
– Improving medication processes and implement
checklists
Slide 21
Combining QI&PS with
Leadership Training and EBM
Jo Inge Myhre, MD
Teaching assistant ”KLoK”
University of Oslo Medical School
Slide 22
Aim of KLoK
Through KLoK you’ll aquire knowledge and skills in
EBM, leadership and quality improvement. This will aid
you in your future professional role as an individual as
well as a member/leader of teams.
Slide 23
Course overview
1. sem.: Introduction to patient safety (lecture)
6. sem.: Leadership and patient safety (seminar)
7. sem.: One week course in EBM (with exam)
10. sem.: EBM, Leadership and QI, Lectures, seminars and individual
assignments during rotations in both hospitals and primary care
–
–
–
Critical analysis of scientific publication and or guideline
Patient satisfaction
”The patient’s journey”
11. semester:
–
–
Lectures and seminars
Group based assignment (QI Project proposal)
12. semester:
–
–
–
”Survival week”
Student-BEST – Interprofessional simulation day
OSCE
Slide 24
Our experience
It’s hard to teach one subject without the others
Making it as clinical as possible is crucial
Invite students in the process
Create mechanism for continuous evaluation of the
course
Slide 25
QUESTIONS?
Email [email protected]
Like us on Facebook
Follow us on Twitter
@IHIOpenSchool
Download our App