JOURNAL OF THE LOUISIANA STATE MEDICAL SOCIETY
Review of the project database maintained by the EQuIP leadership revealed 85 distinct resident-led QI or PS project proposals over the course of the two academic years. Furthermore, the database revealed that rotating residents had submitted and presented nine poster presentations on their EQuIP work. Examples of these proposals include: Transition of Pediatric Patients to Adult Care; Reduction of Time of Specimen Placement inFormalin; and ImprovingCTStudyAppropraiteness.
variety of disciplines. The rotation’s combination of didactics,online educational modules, and practical experiences at the clinical learning environment is effective and prepares residents for future quality and safety challenges in practice. The rotation promotes meaningful participation in system wide initiatives aimed at organizational improvement, particularly in the areas of patient safety and quality of care delivery and has the potential to expand the scholarly activity portfolio of trainees and organizations. The EQuIP curriculum is readily adaptable to training programs of varying sizes and specialties with sufficient buy-in from program directors and hospital leadership.
DISCUSSION
The interprofessional, multimodal, and interdisciplinary approach (comprised of physicians, nursing, and data/quality management analysts) modeled in EQuIP to teach residents about quality improvement and patient safety is both unique and effective. While participation by trainees has not extended to all learners in our environment (currently 10% participate), through increased awareness we are seeing more “buy-in” from program directors who have found thisrotation to be a valuable adjunct to their teaching methods. By structuring a curriculum in this way, residents were able to meet key learning objectives in all six ACGME core competencies including, but not limited to: advancing knowledge in key PS/QI concepts and tools (medical knowledge), defining care quality as a cost variable (medical knowledge), understanding epidemiologic risk factors and prevention strategies surrounding medical error (medical knowledge), reporting of PS events (medical knowledge), generation of ideas for enhanced care delivery systems (patient care, practice based learning and improvement and systems based practice), and confidence in effective communication strategy for uswith theentirehealthcare team(interpersonal and communication skills, professionalism, systems based practice). Added deliverables for resident rotations such as EQuIP include preliminary design of trainee- led PS/QI projects already vetted by institutional quality experts and stakeholders involved. And finally, health care organizations participating in educational programs such as EQuIP also benefit from expanded insight into which organizational areas perceived by residents to be in need of structured improvement projects, and by enhanced health care team coordination and communications that can ultimately drive improved outcomes. Institutions interested in engaging in curriculum similar to that described in the EQuIP rotation, need to first detail their own learning objectives, and then identify their own local expertise in the areas of PS/QI. The collaborative nature of a rotation that involves nursing, physician and administrative leadership has the potential to be highly effective, but significant buy-in from all stakeholders must be ensured. Future development of the rotation would seek to incorporate feedback from the learners about the curriculum and expands its reach across the clinical spectrum to more specialties.
REFERENCES
1. Institute of Medicine (IOM). 2001. Crossing the Quality Chasm: A New Health System for the 21st Century . Washington, D.C: National Academy Press. 2. Federal Register / Vol. 73, No. 226 / Friday, November 21, 2008 / Rules and Regulations. 3. AAMC Policy Guidance on Graduate Medical Education: Assuring Quality Patient Care and Quality Education, Acad Med . 2003 Jan;78(1):112-6. 4. Weiss, KB, Bagian, JP, Wagner, R., Newton, R. (2014) CLER Pathways to Excellence: Expectations for an Optimal Clinical Learning Environment (Executive Summary) . J Grad Medical Educ: September 2014, Vol. 6, No. 3, pp. 610-611. 5. Wagner, R., Patow, C., Newton, R., Casey, B., Koh, N. and Weiss, K. (2016) The Overview of the CLER Program: CLER National Report of Findings 2016. J Grad Med Educ : May 2016, Vol. 8. 6. Bagian, J., Weiss, K. On Behalf of the CLER Evaluation Committee (2016) Overarching Themes: CLER National Report of Findings 2016. J GradMed Educ : May 2016, Vol. 8. 7. Weingart, S. N., Tess, A., Driver, J., Aronson, M. D. and Sands, K. (2004), Creating a Quality Improvement Elective for Medical House Officers. J Gen Intern Med , 19: 861–867. 8. Tomolo AM, Lawrence RH, Aron DC. A case study of translating ACGME practice-based learning and improvement requirements into reality: systems quality improvement projects as the key component to a comprehensive curriculum. PostgraduateMedical Journal 2009;85:530- 537. 9. Institute for Healthcare Improvement. “Introducing the Improved IHI Open School Courses.” Retrieved December 7, 2017 from http://forms.ihi.org/ improved-courses Fred Rodriguez, Jr., MD, Treva LIncoln, BA, C. Leigh Peters, and Murtuza Ali, MD are affiliated with Louisiana State University School of Medicine-New Orleans in New Orleans, LA. D. Blady, RN, E. Roslyn Pruitt, RN, and Robin McGoey, MD are affiliated with University Medical Center in New Orleans, LA.
Treva Lincoln can be reached at tlinco@lsuhsc.edu.
CONCLUSION
The EQuIP rotation at LSUSOM and UMCNO is a unique, interprofessional educational experience, for residents of a
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