ImprovingchapteractivitiestoincreasestudentengagementinQI/PS

KevinShah,BrandonHo,GraceWey,SarahLumsden,MatthewStampfl,ShreyaGoyal,Jesal Shah,Weijie Lin,JustinFu,KatharineYang,Vignesh Ramachandran,Murtaza Saifee,ArielChen,JadenKohn

TheInstituteforHealthcareImprovement(IHI)OpenSchoolChapter- BaylorCollegeofMedicine(Houston,TX)

IntroductionThemissionoftheIHIOpenSchoolChapterofBaylorCollegeofMedicine istoeducate studentsabouttheimportanceofqualityimprovementandpatientsafety(QI/PS),toequip studentswithtools&skillsinQI/PSfortheirfuturecareers,andtoengage studentsinimprovinghealthoutcomesandthepatientexperience.Ouraimforthe2015-2016schoolyearwastoimprovethequalityofourchapteractivitiesandincreasestudentandfacultyengagementinQI/PSinitiativesintheTexasMedicalCenter(TMC).

ChapterObjectives

Recruitment&PDSACycles MentorshipProgram

Hands-onWorkshops

QI/PSLectureSeries QI/PSElectiveQI/PSModulesInitiative

Results Discussion&FuturePlans

•Developabetterunderstandingofthepatientexperience•Learnapracticalskilltoimprovethequalityofpatientcare

Goals

• PurposeofprocessmapsandhowtheyfitintotheQI/PS cycle• Definingtermsand standardsymbols

Intro

• ECFacultypresentedexamplesofcurrentprocessmaps• Highlevelprocessmapofcheck-in/triagedrawnoutbythegroup• Groupsof4participantswereassignedtogatherdetailsfrompatientsandstaffregardingonepartofthehighlevelmap

• Reconvenedasagrouptofillindetailsofprocessmap• Identifyingshortcomingsandgaps• Brainstormingpotentialinterventionsforimprovingpatientcare

Application

• Recognizingthemultiplepiecesthat impactasingleprocess• Addressinghowgapsinprocessesimpactpatientcare

Reflection

ProcessMapWorkshopatBenTaubEmergencyCenter2hours,16participants,1ECnursingfaculty

• Developanunderstandingofinvestigatingmedicalerrors• Gainexposuretohowarootcauseanalysisisperformed

Goals

•Medicalerrorsrelationshiptosystemfailures• Processandorganizationofarootcauseanalysis

Intro

• Writtencasesummarywasusedtobriefstudentson thefactsofamockmedicalerror

• Theindividualsinvolvedinthecase(role-playedby residents)wereinterviewedbystudents

• Thecasewasanalyzedthroughvariousmethodsincludingcreatingaprocessmapandfishbonediagramandaskingthe "fivewhy’s”

• Studentsdevelopedrecommendationstoprevent similareventsfromoccurring inthefuture,analyzingtheirfeasibilityandstrength

Application

• Recognizinghowmedical errorstendtooccur• Addressinghowtopreventmedicalerrorsfromrecurring

Reflection

RootCauseAnalysis(RCA)Workshop2hours,16participants,2qualityimprovementchiefs

Recruitment

• StudentsthatcompletedBCM’sPatientSafetycoursewererecruitedtocompletetheIHIBasicCertificateinQualityandSafety

• Outreachthroughannouncements, socialmedia,andemail

ModuleCompletion

• Pre-ProgramQuestionnairewasgiventoassessknowledge,behaviors,andattitudesregardingQI/PS

• Studentsparticipatedinan8-weeklongitudinalcourseintheIHIOpenSchoolonlinelearningmodules

Discussion

•Studentshadformaldiscussionsregardingcases,QI/PStools,andlessonslearnedaftercompletingthemodules•Post-ProgramQuestionnairewasgiventoassessknowledge,behaviors,andattitudesregardingQI/PS

TheBCMchapterofIHIwasproudtohostDr.DavidBerger,theDirectorofSurgicalQualityatBaylorCollegeofMedicineandChiefOperatingOfficer(COO)ofBaylor-St.Luke’sHospitalSystem,foratalkregardinghisstart-upcompany,SyncedCare.

Thegoalofthislecturewastosupplementgapsinmedicaleducationthatareoftenoverlooked, suchastheintersectionofbusiness,entrepreneurship,andmedicine. Dr.Bergeremphasizedtheburgeoningneed fortechnologicalsolutionstohealthcareproblems,andencouragedstudentstostrivetofillthisneedbydevelopingtheirownproductswiththeirclinicalexpertise.HesharedwithustheprocessbehindhisdesignofSyncedCare’s individualizedandintuitiveuserinterfacewhichimprovesuponpatient-physiciancommunication.

Structure:TheBCMIHIMentorshipprogramconsistsofgroupsof1-2studentstoonefacultymentor.StudentswererequiredtocompleteIHImodulesQI101/102beforeinitialmeetingwithmentorswithadditionalrecommendedmodulestobecompletedthroughout theyear.Thegoalsoftheprogramaretoeducatestudentsabout thegeneralprinciplesofQI/PS,exposestudentstocareersinQI/PS,andenhanceopportunities forstudentstoparticipateinQI/PSprojects.

Recruitment: 12facultymentorswererecruitedfromawidevarietyoffieldsincludingMedicine,Pediatrics,Surgery,andRadiology. Atotalof16medicalstudentsenrolledintheprogram(10secondyearstudentsand6thirdyearstudents).

Meeting1 (September-October2016)Goals:• RequiredModules:QI101&QI102• LearnaboutimplementingQI/PSinvariouscareerpaths• Discussstudent’spastexperiences,careergoals,

researchinterests,andexpectationsofmentorshiprelationship

Meeting2(November2016– January2017)Goals:• RecommendedModules:QI103,QI104,&QI105• Learnhowtogetinvolved inQI/PSinitiativesasa

student• DiscusswhattoexpectinaQI/PSproject• UnderstandhowtostartaQI/PSproject

Spring(January - June2017):Self-directedmeetingswithmentors• Recommendedmodulesforcompletion:QI201,QI202,&QI301• Developingastudentresearchproject• Collaboratingonpreexistingresearchproject

AdministrationofPre-ProgramQuestionnaire

Objective1: Increase thenumberofchapteractivitiesandgrowparticipationbypromoting eventstoallhealthcarestudents

Objective2: Improve thequality,quantity,andmeansofobtainingfeedback/datafromworkshops, programs,andactivities

Objective3: Provideandfacilitatecareerdevelopmentopportunities forstudentsinterestedin QI/PS

Education/Networking:• EventsforgroupviewinganddiscussionsofIHI

QI/PSInstructionalVideos• Utilizationofchapterinter-institutional

coordinator toincreasenon-BCMstudent/facultyparticipation

• TMCYoungProfessionalsCollaboration:HostanIHIbooth andparticipateinthenetworking fair

CommunityEngagement:• ParticipateinI-CANtrainingthisMarch2017• ProjectTopicsinBrainstormingPhase

o AssessmentofRiskStratificationforPediatricpatientsusingAdverseChildhoodExperiencesquestionnaires

o PatientEducationregardingend-of-lifeorpalliativecare

• Developanunderstandingofcommunicationprocesses• Learn andapplyastandardizedhandoffsmethodology

Goals

• Purposeandrelevanceofeffectivehandoffsinhealthcare• Situationsandclinicalsettingsinwhichhandoffsoccur

Intro

• Discussionoftheimportanceofhandoffsinpreventingmedicalerrorsandadverseevents

• Studentspracticenon-clinicalhandoffandreceivefeedbackfrominstructor&peers

• StudentslearnIPASS(IllnessSeverity,PatientSummary,ActionList,Suggestions,Synthesis)methodologyforhandoffs

• StudentspracticeclinicalhandoffsusingIPASSmethodologywithfeedbackfrominstructor&peers

Application

• Recognizingthecomponentsofaneffectivehandoff• Addressinghowhandoffscanimpactpatientcare

Reflection

HandoffsWorkshopatBaylorCollegeofMedicine1 hours,14participants,1Instructor

StudentOrganizationFair:• DisplayedposterboardshowcasingIHI

OpenSchoolChapteractivities• ChapterOfficersrecruitedstudentsof

variousdisciplinestoattendIntroduction&PDSAMeeting

Introduction&PDSAMeeting:• Discussedgoals,mission,vision,and

activities• IntroducedstudentstoPlan-Do-Study-

Act(PDSA)CycleandtheIHIModelforImprovement

IHIOpenSchoolActivity #ofParticipants

IntroMeeting&PDSACycles 17

MentorshipProgram* 16

HandoffsWorkshop 14

ProcessMappingWorkshop 16

Root-Cause-AnalysisWorkshop 16

QI/PSBasicCertification* 35

SyncedCareLecture* 17

QI/PSElective* 5

AnnualQI/PSConference 258

*indicatesneweventsstartedbyIHIsince August 2016

AdministrationofPost-ProgramQuestionnaire

Overall:• Fourneweventswereaddedin2016to

increasechapterengagement• PDSAmethodology wasimplemented to

improveupon currenteventsandthecollectionofinternalqualityimprovementdata

Workshops:• Learners’confidenceinperforming skillswasassessedvia5-pointLikertscale.Improvedconfidencewasseenforeachskill:Handoffs(meandifference2.43,p<0.0001),ProcessMapping (meandifference1.50,p<0.0001)andRCA(meandifference1.69,p<0.0001)

• Overall,82.6%oflearnersagreedthattheworkshopswereusefuland91.3%oflearnerswerelikelytorecommendittoothercolleagues

FormationofIHIStudentElectiveSubcommittee

SyllabusDevelopment

IdentificationofFacultytoBecomeCourseDirectors

MeetwithCourseDirectorstoSolidifySyllabus&Course

Objectives

SubmitElectivetoCurriculum

CommitteeforApproval

CourseDirectorsIdentify&ScheduleFacultytoLeadEach

Module

FinalizeCourseSyllabustoIncludeHands-onLearning

IHIStudentSubcommittee

ManagesOutreachtoRecruitStudents

forElective

StudentsProvideFeedbacktoFacultyRegardingElective

Content

CourseContent

RootCauseAnalysis

ProcessMapping Measures&RunCharts

HumanFactorsEngineering

TheSecondVictim Communication &Quality

Simulation&Quality

HighValueCare