IHI Open School

Quality Improvement/Patient Safety

The IHI Student Consortium

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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