Te4Q Educational Project Review Project Title: Designing a Patient Safety/Quality Improvement Curriculum for Graduate Medical Education Participant Names: Franklin D. Shuler, MD, Ph.D., Eva Patton-Tackett, MD, Ellen Thompson, MD, Rodhan Khthir, MD, Nancy Munn, MD, Farid Mozaffari, MD, Maria Tirona, MD and Jo Ann Raines, M.A.

Project Objectives 1. To identify how prepared our current residents and fellows are in meeting the new patient safety and quality improvement competency requirement; 2. To collaboratively devise curriculum implementation strategies, tools and techniques needed to assist our trainees meet this requirement

Overview of Need The seven of the 13 Residency and Fellowship Program Directors who participated in this day and one-half program identified a quality improvement and patient safety curriculum gap and structured a required independent learning rotation structure. Additionally, Residents and Fellows were surveyed and asked about their knowledge level and how prepared they were in meeting the new patient safety and quality improvement competency requirement. This PS/ QI Curriculum proposal is designed to supplement and enhance current program offerings and requirements.

Educational Design and Strategies AMA Introduction to Practice of Medicine (IPM) The AMA Introduction to Practice of Medicine is a web-based educational series that will complement and reinforce what is being taught in patient settings and didactic curriculum in resident and fellowship training programs. Required Modules: 1. Patient Safety: Further Steps to Prevent Patient Harm 2. Patient Safety: Identifying Medical Errors 3. Patient Safety: National Patient Safety Goals 4. Quality Improvement Panel 5. Quality Improvement: Q & A

PS/QI Curriculum Goal/Aim To require each trainee to complete the following by the end of their JCESOM training: Participation in required online modules in PS/QI Certificates of completion of online modules; Participation in a PS/QI Project; Further requirements and time-lines will be set by each specific Department.

Learning Objectives Knowledge -- Define the processes of PS/QI; Comprehension -- Recognize the benefits of QI and identify the key PS/QI concepts and principles; Application -- Perform a simulated root cause analysis as a demonstration of PS/QI principles and knowledge; Analysis -- Inventory current PS/QI projects and continually analyze opportunities for PS/QI; Synthesis -- Participate in a QI project and present a QI project in an Annual QI Poster Presentation Day.

Educational Design and Strategies Assessment Survey/ test Resident QI committee Residents QI ind. profile Est 5 clinical focus areas Clinical focus area teams Establishing dashboard for IM Complete online training Attend mandatory lectures Quarterly quality council meeting EBM and critical appraisal training Post call PICO project Monthly rounds and tracers Auditing by AMA/ New Innovations Quality tools competency testing Data anal &SPC chart competency Participate in PI training participate in RCA training Participate in FMEA training Present PI, RCA or FMEA evaluation and 1:1 meeting Knowledge assessment program evaluation/ planning Knowledge of QI concepts will be obtained through web-based modules, supplemented with didactic lectures. Simulated root cause analysis will be a web-based module. Knowledge and tools gained will be applied in a QI project.

Learner Assessment Knowledge of QI will be assessed by: Certificates of completion from the on-line modules sponsored by the AMA Presentations of completed QI projects Practical Application of QI Projects will be reviewed by other residents and the PD office Presentations will be given on the QI project to Inter-professional teams

Program Evaluation Feedback from the learners will be obtained during semi-annual evaluations. Quantity/Quality of projects that are submitted Completion rate of on-line learning modules Resident/fellow ability to demonstrate competence Resident/fellow ability to complete milestones Improvements will be made based upon the information obtained from above and adjustments will be made accordingly.

Implementation How many learners will participate? All Residents/Fellows- 186 Estimated Implementation Time? Will Start upon GMEC approval – July 1, 2015 Confidence regarding completing project- VERY Anticipated barriers Will Need “Buy In” from All of Partners EXCEPT AMA Resources Needed: Finances for AMA Modules Staff for Monitoring Completion Rates Program Directors Cheerleading and Incorporation of Lectures

Implementation Approval of this curriculum will be presented to GMEC at next meeting (Feb. 2015) Implementation – July 2015 QI Poster Presentation – November 14, 2014

Additional Activities Are there other educational activities aside from this project that you will implement? Will work cooperatively with other Te4Q proposals Co-sponsor Joint QI Poster Presentation Day