IHI Open School
Quality Improvement/Patient Safety
The IHI Student Consortium
IHI Open School
The Quality Project
Presented by the IHI Student Consortium
The Quality Project is a collaboration among preclinical and clinical students, residents, fellows, faculty, and administrators across Stanford. Our mission is to develop higher quality healthcare that is more safe, effective, patient-centered, timely, efficient, and equitable through education, research, advocacy, and implementation.
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IHI Student Consortium
Education Research Advocacy Implementation
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Education Research Advocacy Implementation
- Leadership Course- QI Lecture Series- QI Clinical Elective - QI in Q6
- Med-Scholars- Internal Medicine Program- Hand Hygiene Project- Leadership Training in Medicine
- Global Safe Surgery Mentor Project- Patient-Centered Care in Fellowship- CBEI & Quality- Team Easy
- Hospital Management Collaborative- Hand Hygiene: Implementation- Pacific Free Clinic Quality Initiative
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Medical Leadership Development
Matthew Goldstein, SMS VIRobin Eisenhut, SMS IIIBarnard Palmer, MDTiffany Castillo, SMS V
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Initiated in 2008PEDS 201: 1 unit, Fall Quarter
Course Director: Charles ProberFacilitator: Julia Tussing
Students: Received 40 applications for 8 medical student spots 8 Medical Students (Years 1-3) 4 Chief Residents (Medicine, Surgery, Pediatrics, Psychiatry)
Topics: What is Leadership? Self-Knowledge Communication & Emotional Intelligence Conflict Management Influence Effective Teams
Leadership Training in Medicine
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As a leader I…
…encourage everyone to speak their mind ** P = .0082
…ask you to take positions that support your core values * P = 0.030
…seek feedback to improve interactions with others ** P = 0.0038
…show that I understand how specific actions impact others * P = 0.030
Conflict Management I am capable of giving constructive feedback * P = 0.030
Self-Awareness
I have a deep understanding of my strengths, weaknesses, needs, and drives. * P = 0.0465
I am honest with myself. * P = 0.030
I undertake realistic self-assessment. ** P = 0.0082
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Testamonial:Would you recommend the MLD course to others? Do you believe leadership skills should be taught to medical professionals?
“Yes and yes. I believe leadership skills are learned, and for those who have access to those skills it is a great benefit. As someone who does not have family in the medical field, it was invaluable to hear the stories of some leaders in the field and reflect on and discuss many aspects of leadership that will serve me well as I progress through training and in shaping my career.”
“Yes, and YES! Simply talking about it prompts reflection, and makes each of us better leaders. This course coincided with a lot of challenging situations in my own academic/work life, and it was a great compliment to my own personal development since it forced me to take some time and just think. I also think it is important for students to see leaders who did not necessarily know which way was up at some point in their lives. In this way the course also foster humanity and humanism, and we cannot be doctors without that.”
“YES YES YES. Leadership skills should def be taught to medical professionals. MDs are kind, hard working, compassionate individuals but sometimes in my experience I have seen that they do not take charge and try to make a change as much as their skills should allow them to.”
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Future Iterations…
The Ideal: full-year, independent
course
integrated into curriculum
more of a t-group model
inter-disciplinary effort between GSB and SoM
mandatory for all students
The Reality: insert or piggy-back on select
components in existing curricula if all students are to be exposed
continue to offer an elective or encourage students to utilize GSB/VPGE leadership courses
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Internal Medicine QI Elective & A Hand Hygiene Project
Kambria Hooper, M.Ed.Stephanie Carr, SMS III
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Internal Medicine QI Elective Initiated in 2010
MED 344A: 6 unit, Any QuarterCourse Director: Clarence Braddock
Topics: Mentored practice and growth in knowledge, skills, and attitudes in
quality improvement, patient safety, and organizational change Directed readings, attend sessions with experienced QI champions Learn about quality improvement projects and processes at Stanford
University Participate in ongoing quality and patient safety activities within the
Department of Medicine and Stanford Hospital and Clinics Design and begin a quality improvement/patient safety/organizational
change project Develop a mentoring relationship with a QI champion who will serve as
a role model, mentor, and educator
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Stephanie Carr: Hand Hygiene – Follow the Leader? Hypothesis:
To determine whether the hand hygiene habits of attending physicians or the first person entering/exiting the patient room influenced the compliance of other physician team members.
Method: Four medical students individually shadowed physician teams
during morning rounds and measured hand hygiene compliance
Results: Physician team members were more likely to wash their hands
upon entering and exiting patient rooms if their attendings washed (75% v. 29%; p < 0.001)
Team members were also more likely to wash if the first person entering/exiting washed (75% v. 31%; p < 0.001)
Conclusion: Efforts to improve hand hygiene compliance should be directed
towards the attendings.
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Team Easy:
Incorporating Quality Improvement (QI) into Stanford Medical Curricula
Shubha Bhat, SMS IINatalia Leva, SMS IIFelipe Perez, SMS IIJulia Pederson, SMS IIStephanie Smith, SMS II
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Team EASY: advocacy project• Goal: Incorporate QI training into longitudinal
medical curriculum• Process: Needs assessment with stakeholders• Outcomes:
– “QI in Q6" pilot project, June 2010– Recommendations for QI Core Competencies– CCAP working group formed
• Next steps: – Build support and interest among students and faculty– Develop, pilot, and implement QI curriculum
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Team Easy Advocacy Project
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Team Easy: Stanford QI Training Environment
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The Hospital Management CollaborativePromoting Patient Safety Entrepreneurship
Nirav Kamdar, MD MPPDepartment of Internal Medicine
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HMC Class
IHI Breakthrough
Projects
QI ResidentElective
QI Team Challenge
Clinical Effectiveness
CERC
Quality WorkingGroups
Quality Council
QIPSC
Education SOM Centers
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Create a health system modeling pipeline Provide access to primary data Provide exposure to real health management
problems Provide a client experience with support Increase academic leadership in quality
improvement Increase resident publication opportunities
HMC: Goals
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HMC: What we need…
Single roundtable meeting with multidisciplinary faculty
Direct interaction with CERC’s strategic plan Organizational personnel to develop HMC course
and coordinate project teams
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Conclusions
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Align student initiatives with faculty/administration projects already underway
Help facilitate a round table meeting with multidisciplinary faculty and students*
Provide students with opportunities for internships, rotations, and research in the QI/PS space
Incorporate quality improvement and patient safety as a core competency throughout undergraduate and graduate medical education
Conclusions