EXPERIENTIAL LEARNING TO

TEACH QUALITY IMPROVEMENT: REFLECTIONS FROM COACHES AND

LEARNERS

Brigitte Smith, M.D.

Assistant Professor of Vascular Surgery

Diane Liu, M.D.

Assistant Professor of Pediatrics

Susan Pohl, M.D.

Assistant Professor of Family & Preventive Medicine

• Brigitte Smith, M.D. • Assistant Professor of Vascular Surgery

• Director, Surgery Resident Value Curriculum

• Co-Director, Medical Student Value Curriculum

• Diane Liu, M.D., FAAP • Assistant Professor Pediatrics

• Director of UT Pediatric Partnership to

Improve Healthcare Quality

• Associate Chief Value Officer, Dept of Pediatrics

• Susan Pohl, M.D., FAAFP • Assistant Professor of Family Medicine

• Director of Family Medicine Residency QI Curriculum

Small Group Discussion Outline

1) Institutional infrastructure and resources that can

support QI curricula

2) QI Competencies in Medical Education

3) QI Educational Strategies

4) Management of Learner QI Projects

5) Learner Reflections

•Health Systems Science

•Quality Improvement

•Patient Safety

Value-Driven Healthcare

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• Organizational Culture

• Teaching Hospital –

GME Alignment

• Infrastructure

• Curricular Resources

• Faculty Development

• Inter-Professional

Collaboration

College of Pharmacy

School of Dentistry

College of Health

Eccles Library

School of Medicine

College of Nursing

UofU Health Sciences

Department of Surgery

Rob Glasgow, Chief

Value Officer

Alan Smith,

GME

UME

Pam Proctor, Director of

Patient Safety

Sandi Gulbransen,

Director of Quality

Lorie Gillette, Director of

Value Management Chrissy Daniels,

Director of Strategic

Initiatives

Ryan Murphy, Value

Fellow Tom Miller, CMO

Robert Pendleton, CMQO

Luca Boi

Senior Value Engineer

College of Pharmacy

School of Dentistry College of Health

Eccles Library School of Medicine

College of Nursing

UU Health Sciences

Department of Surgery

Rob Glasgow, Chief

Value Officer

Alan Smith,

GME

UME

Pam Proctor, Director of

Patient Safety

Sandi Gulbransen,

Director of Quality

Lorie Gillette, Director of

Value Management Chrissy Daniels,

Director of Strategic

Initiatives

Ryan Murphy, Value

Fellow

Tom Miller, CMO

Robert Pendleton, CMQO

Luca Boi

Senior Value Engineer

UU Hospital & Clinics

Quinn McKenna, COO

Charlton Park (interim),

CFO

Steve Johnson

Value Engineer

Candace Crawford

Chief of Decision Support

Charlton Park

Chief of Analytics

VDO Tool UHPP

Program

Analytics

Hub

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Resources

•Pulse

• Value Summary Portal

• Accelerate • http://healthsciences.utah.edu/accelerate/

• Video learning modules • https://pulse.utah.edu/site/VSum/Pages/Training/Home.

aspx

•Value Improvement Leaders course

•Value Engineers

• Luca Boi

ACGME Core Competencies

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SBP & PBLI

• Systems-Based Practice (village)

• Advocate for quality systems of patient care

• Enhance patient safety

• Improve patient care quality

• Participate in identifying system errors

• Implement potential systems solutions

• Practice-Based Learning and Improvement (mirror)

• Analyze practice using quality improvement methods

• Implement changes with the goal of practice improvement

Milestones

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What level of competence is expected of

your learners?

Educational Strategies

• What are the key things that you need to determine?

• Who will teach the content? How? When?

• What level of learner?

• Who will advise / guide trainees through their project?

• Who are your helpers?

• Experiential learning (IHI Framework)

• Team-based

• Unit-based

• System-based

Educational Strategies

• Team-based model often most realistic / achievable

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What are our curricula?

Create

Flow

Improve

Quality

Eliminate

Waste

Lean

PDSA

6s

D M A I C

PLAN

DO

ACT

STUDY

Value Improvement Framework

1. Project Definition

2. Problem & Goal Statement(s)

3. Baseline Analysis & Investigation

4. Improvement Design &

Implementation

5. Monitoring

6. Impact

QI Projects

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Managing Learner QI Projects:

Discussion & Learner Reflections

•What has failed? / What has gone well?

•Challenges

• How did you address them?

•#1 Lesson Learned

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1. Buy-in

2. Overload

3. Shared vision

4. Clarity of content

5. Culture

6. Value of resident work

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WHAT IMPROVEMENT (REALLY) LOOKS LIKE

identify problem

JK

START END

AHA! found the real problem

keep going!

set goals

assemble the team

now we have the right team

analysis & investigation

design improvement

implement

Questions?