Northwestern Family Medicine Residency & Erie Family Health Center Making Scholarly Activities Meaningful: Using Quality Improvement Projects and Team-based care to Engage Residents in Research Santina Wheat MD, MPH, Anuj Shah MD, MPH, & Mary R. Talen PhD Northwestern Family Medicine Residency & Erie Family Health Center

Disclosures The presenters have nothing to disclose

Objectives Describe the goals and objectives of the Scholarly Activity Rotation, QI and team-based care curriculum Describe the learning activities from chart reviews, faculty feedback, review of population-data, and team-based, community-focused interventions. Identify opportunities and barriers for Scholarly Activities, QI-Team-based care curriculum in healthcare settings

ACGME Requirements The faculty must establish and maintain an environment of inquiry and scholarship with an active research component. Some members of the faculty should also demonstrate scholarship Faculty should encourage and support residents in scholarly activities. peer-reviewed funding; (Detail) publication of original research or review articles in peer reviewed journals, or chapters in textbooks; (Detail) publication or presentation of case reports or clinical series at local, regional, or national professional and scientific society meetings; or, (Detail) participation in national committees or educational organizations. (De

ACGME Requirements cont Residents are expected to develop skills and habits to be able to meet the following goals: systematically analyze practice using quality improvement methods, and implement changes with the goal of practice improvement

ACGME Requirements Cont There must be a structured curriculum in which residents address population health, including the evaluation of health problems of the community.

ACGME Requirements Cont Residents’ Scholarly Activities The curriculum must advance residents’ knowledge of the basic principles of research, including how research is conducted, evaluated, explained to patients, and applied to patient care. Residents should participate in scholarly activity. Residents should complete two scholarly activities, at least one of which should be a quality improvement project. The sponsoring institution and program should allocate adequate educational resources to facilitate resident involvement in scholarly activities.

So how can we accomplish this?  Hate this Most of our residents don’t want to do research, they want to be doctors Much rather do this 

Choose an Individual or Team Project Our Solution Foundation IHI Modules FPIN Modules CITI Training Team Based QI AAFP Metric ABFM Part IV Organizational QI Session Choose an Individual or Team Project FPIN submission Group Scholarship Project Individual Project

PGY 1 PGY 2 PGY 3 Curriculum Overview Participate in Metric Introduction to Requirements PGY 1 Dedicated Research Month, complete foundation learning Participate in quarterly research sessions Organizational QI Session Choose and start 2nd project BH month – Depression metric with focus on population management PGY 2 Refine and complete 2nd project Present at research day and outside forum PGY 3

Foundational Activities Citi Training – Social Sciences Institute for Healthcare Training Modules Patient Safety Quality Improvement FPIN Modules Literature Review (Global and Focused) Strength of Evidence Overview of Statistics More if want to do Help Desk Answer Describe each activity

Team Based QI Project Faculty select Metric Topic Organization QI pulls patient lists Residents and Team Faculty Member review patient level data Residents look at how they are doing Faculty link to milestones Residents decide on PDSA for clinic

Team Based QI Project Implement improvement process Organization QI pulls patient lists Residents and Team Faculty Member review patient level data Residents look at how they are doing Faculty link to milestones Debrief

Team Based QI Project Satisfies requirement for QI project Complete ABFM Part IV requirement Experience utilizing team based model Faculty can also complete Part IV requirement

Individual or Team Project Option of FPIN article Individual or team designed QI projects (IRB exempt) Individual or team designed scholarly project describe

Organizational Support for Projects Translational Team-based Projects Community Health Centers Collaboration with Alliance: EMR system Academic Opportunities NW’s Institute for Public Health and Medicine PBRN

Outcomes Translational Team-based Projects CHC Academic Partnerships HTN QI Metric and Patient Education Videos Asthma Metric and ACT forms and Asthma Fair CHC RAAPS Pilot Project: CHC and CDC funded pilot Academic Partnerships Aligning Chicago Public School Health data with Hospital and Healthcare Network Data (Capricorn)

Outcomes Completed 3 Metrics over past year with 22 residents Training for Residents and Faculty in FPIN model 2 publications 4 in progress Numerous presentations at Local, National and International Conferences

Barriers & Lessons Learned Time, time, time! Multiple review boards Resident engagement in QI project (don’t understand importance till last minute) Initially only 1 faculty author for FPIN QI team turned over Managing resident expectations

Barriers & Lessons Learned Time, time, time! Multiple review boards Resident engagement in QI project (don’t understand importance till last minute) Initially only 1 faculty author for FPIN QI team turned over Managing resident expectations Research month with weekly meetings and clear expectations Faculty member joining clinic review committee Completing 2x yearly to make part of culture Made faculty development theme scholarship for academic year and did FPIN workshop Need to be thoughtful about what and how we are asking for things Clearly set expectations of what can be accomplished in 1.5-2 years at beginning month R

Next steps Faculty to complete FPIN HDA Regular meetings with QI for assistance Move some of the foundational activities to PGY 1 orientation Align metric topics with clinic Enterprise goals to involve all clinic staff Applied for grant to allow more clinic-wide work on panel management Plan to encourage all to do FPIN HDA so everyone can pu

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