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Improving chapter activities to increase student engagement in QI/PS Kevin Shah, Brandon Ho, Grace Wey, Sarah Lumsden, Matthew Stampfl, Shreya Goyal, Jesal Shah, Weijie Lin, Justin Fu, Katharine Yang, Vignesh Ramachandran, Murtaza Saifee, Ariel Chen, Jaden Kohn The Institute for Healthcare Improvement (IHI) Open School Chapter - Baylor College of Medicine (Houston, TX) Introduction The mission of the IHI Open School Chapter of Baylor College of Medicine is to educate students about the importance ofquality improvement and patient safety (QI/PS), to equip students with tools & skills in QI/PS for their future careers, and to engage students in improvinghealth outcomes and the patient experience. Our aim for the 2015-2016 school year was to improve the quality of our chapter activities and increase student and faculty engagement in QI/PS initiatives in the Texas Medical Center (TMC). Chapter Objectives Recruitment & PDSA Cycles Mentorship Program Hands-on Workshops QI/PS Lecture Series QI/PS Elective QI/PS Modules Initiative Results Discussion & Future Plans •Develop a better understanding of the patient experience •Learn a practical skill to improve the quality of patient care Goals • Purpose of process maps and how they fit into the QI/PS cycle • Defining terms and standard symbols Intro • EC Faculty presented examples of current process maps • High level process map of check-in/triage drawn out by the group • Groups of 4 participants were assigned to gather details from patients and staff regarding one part of the high level map • Reconvened as a group to fill in details of process map • Identifying shortcomings and gaps • Brainstorming potential interventions for improving patient care Application • Recognizing the multiple pieces that impact a single process • Addressing how gaps in processes impact patient care Reflection Process Map Workshop at Ben Taub Emergency Center 2 hours, 16 participants, 1 EC nursing faculty • Develop an understanding of investigating medical errors • Gain exposure to how a root cause analysis is performed Goals • Medical errors relationship to system failures • Process and organization of a root cause analysis Intro • Written case summary was used to brief students on the facts of a mock medical error • The individuals involved in the case (role-played by residents) were interviewed by students • The case was analyzed through various methods including creating a process map and fishbone diagram and asking the "five why’s” • Students developed recommendations to prevent similar events from occurring in the future, analyzing their feasibility and strength Application • Recognizing how medical errors tend to occur • Addressing how to prevent medical errors fromrecurring Reflection Root Cause Analysis (RCA) Workshop 2 hours, 16 participants, 2 quality improvement chiefs Recruitment • Students that completed BCM’s Patient Safety course were recruited to complete the IHI Basic Certificate in Quality and Safety • Outreach through announcements, social media, and email Module Completion • Pre-Program Questionnaire was given to assess knowledge, behaviors, and attitudes regarding QI/PS • Students participated in an 8-week longitudinal course in the IHI Open School online learning modules Discussion •Students had formal discussions regarding cases, QI/PS tools, and lessons learned after completing the modules •Post-Program Questionnaire was given to assess knowledge, behaviors, and attitudes regarding QI/PS The BCM chapter of IHI was proud to host Dr. David Berger, the Director of Surgical Quality at Baylor College of Medicine and Chief Operating Officer (COO) of Baylor-St. Luke’s Hospital System, for a talk regarding his start-up company, SyncedCare. The goal of this lecture was to supplement gaps in medical education that are often overlooked, such as the intersection of business, entrepreneurship, and medicine. Dr. Berger emphasized the burgeoning need for technological solutions to healthcare problems, and encouraged students to strive to fill this need by developing their own products with their clinical expertise. He shared with us the process behind his design of SyncedCare’s individualized and intuitive user interface which improves upon patient-physician communication. Structure: The BCM IHI Mentorship program consists of groups of 1-2 students to one faculty mentor. Students were required to complete IHI modules QI101/102 before initial meeting with mentors with additional recommended modules to be completed throughout the year. The goals of the program are to educate students about the general principles of QI/PS, expose students to careers in QI/PS, and enhance opportunities for students to participate in QI/PS projects. Recruitment: 12 faculty mentors were recruited from a wide variety of fields including Medicine, Pediatrics, Surgery, and Radiology. A total of 16 medical students enrolled in the program (10 second year students and 6 third year students). Meeting 1 (September-October 2016) Goals: • Required Modules: QI101 & QI102 • Learn about implementing QI/PS in various career paths • Discuss student’s past experiences, career goals, research interests, and expectations of mentorship relationship Meeting 2(November 2016 – January 2017) Goals: • Recommended Modules: QI103, QI104, & QI105 • Learn how to get involved in QI/PS initiatives as a student • Discuss what to expect in a QI/PS project • Understand how to start a QI/PS project Spring (January - June 2017): Self-directed meetings with mentors • Recommended modules for completion: QI201, QI202, & QI301 • Developing a student research project • Collaborating on preexisting research project Administration of Pre-Program Questionnaire Objective 1: Increase the number of chapter activities and grow participation by promoting events to all healthcare students Objective 2: Improve the quality, quantity, and means of obtaining feedback/data from workshops, programs, and activities Objective 3: Provide and facilitate career development opportunities for students interested in QI/PS Education / Networking: • Events for group viewing and discussions of IHI QI/PS Instructional Videos • Utilization of chapter inter-institutional coordinator to increase non-BCM student/ faculty participation • TMC Young Professionals Collaboration: Host an IHI booth and participate in the networking fair Community Engagement: • Participate in I-CAN training this March 2017 • Project Topics in Brainstorming Phase o Assessment of Risk Stratification for Pediatric patients using Adverse Childhood Experiences questionnaires o Patient Education regarding end-of-life or palliative care • Develop an understanding of communication processes • Learn and apply a standardized handoffs methodology Goals • Purposeand relevance of effective handoffs in healthcare • Situations and clinical settings in which handoffs occur Intro • Discussion of the importance of handoffs in preventing medical errors and adverse events • Students practice non-clinical handoff and receive feedback from instructor & peers • Students learn IPASS (Illness Severity, Patient Summary, Action List, Suggestions, Synthesis) methodology for handoffs • Students practice clinical handoffs using IPASS methodology with feedback from instructor & peers Application • Recognizing the components of an effective handoff • Addressing how handoffs can impact patient care Reflection Handoffs Workshop at Baylor College of Medicine 1 hours, 14 participants, 1 Instructor Student Organization Fair: • Displayed poster boardshowcasingIHI Open School Chapter activities • Chapter Officers recruited students of various disciplines to attend Introduction& PDSA Meeting Introduction & PDSA Meeting: • Discussed goals, mission, vision, and activities • Introduced students to Plan-Do-Study- Act (PDSA) Cycle and the IHI Model for Improvement IHI Open School Activity # of Participants Intro Meeting & PDSA Cycles 17 Mentorship Program* 16 Handoffs Workshop 14 Process Mapping Workshop 16 Root -Cause-Analysis Workshop 16 QI/PS Basic Certification* 35 Synced Care Lecture* 17 QI/PS Elective* 5 Annual QI/PS Conference 258 *indicates new events started by IHI since August 2016 Administration of Post-Program Questionnaire Overall: • Four new events were added in 2016 to increase chapter engagement • PDSA methodology was implemented to improve upon current events and the collection of internal quality improvement data Workshops: • Learners’ confidence in performing skills was assessed via 5-point Likert scale. Improved confidence was seen for each skill: Handoffs (mean difference 2.43, p<0.0001), Process Mapping (mean difference 1.50, p<0.0001) and RCA (mean difference 1.69, p<0.0001) • Overall, 82.6% of learners agreed that the workshops were useful and 91.3% of learners were likely to recommend it to other colleagues Formation of IHI Student Elective Subcommittee Syllabus Development Identification of Faculty to Become Course Directors Meet with Course Directors to Solidify Syllabus & Course Objectives Submit Electiveto Curriculum Committeefor Approval Course Directors Identify & Schedule Faculty to Lead Each Module FinalizeCourse Syllabus to Include Hands-on Learning IHI Student Subcommittee Manages Outreach to Recruit Students for Elective Students Provide Feedback to Faculty Regarding Elective Content Course Content Root Cause Analysis ProcessMapping Measures & Run Charts Human Factors Engineering The Second Victim Communication & Quality Simulation & Quality High Value Care

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Page 1: Improving chapter activities to increase student ... · The mission of the IHI Open School Chapter of Baylor College of Medicineis to educatestudents about the importance of quality

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

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