Integrating Quality and Education Defining and creating educational interventions to improve health, healthcare and innovation

Why Quality Improvement and Education? 1) The patient’s perspective

2) The National view: Dartmouth Atlas HbA1c data

3) The Reports (among them, Teaching for Quality, 2013) The Te4Q Vision: Quality Improvement is core to what it means to be a physician A Recommendation: “Every academic health center will have a critical mass of faculty ready, able and willing to engage in, role model, and teach about patient safety and the improvement of health care”

AAMC’s Educational Response - an outgrowth of the Integrating Quality initiative Aligning and Educating for Quality (ae4Q)  A consultative service focused on organizational and educational methods to improve quality  Initiated 2012 Teaching for Quality (Te4Q)  A faculty development initiative  Initiated 2014

ae4Q: aligning and educating for quality An educational process Use of quality metrics in planning and assessment Use of evidence based interventions (including HIT, team training, staff development) A suggested organizational alignment of CME and GME, QI/PI initiatives, practice plans, electronic health records, faculty/staff development, credentials… On-line Resources, Community of Practice

ae4Q sites, Feb, ‘15

Two examples of ae4Q initiatives Quality Rounds Apply quality metrics to planning process Convert quality gaps into learning objectives Develop effective, interactive educational rounds; or series of rounds May repeat theme or gap Evaluate outcomes M&M Conferences – MM&I Use systems-based approach Review several or more cases, de- emphasizing single case Explore causal factors Explore and refine improvement efforts Report at subsequent rounds

Some achievements….. AMC outcomes Patient care, process & educational improvements* Re-alignment of CME with other entities; clinical/ CME committee representation Champions, recognition of value of CME Organizational MOC ? cost savings ? imbedding QI/PS into the culture of an institution Others… Our joint products Markers of organizational readiness: alignment, educational effectiveness, champions, drivers and barriers Resources to facilitate the integration Sharing of Best Practices; Communities of Practice Dissemination of results; publications; presentations Davis, N et al, Acad Med, 2013 Pingleton S et al, Acad Med, 2013

The Te4Q engagement Pre-Requisite: some knowledge of QI/PS Self- & Organizational-Readiness Assessments Pre-reading Skill Building Workshop Extensive workbook covering principles of effective teaching, learning, curricular design and assessment QI Educational Project w/presentation in 3 mo. Community of Practice Dissemination of Work—Presentation or Publication Certificate

Te4Q Sites (Phase 1) Northeast RegionWorkshops held Geisinger Health System*April 2014 Jefferson School of Population Health November 2014 (affiliated with The Sidney Kimmel Medical College at Thomas Jefferson University) North Shore Long Island Jewish Health SystemSeptember 2014 Stony Brook University School of MedicineDecember 2014 University of Rochester School of Medicine and Dentistry October 2014 Southern Region Marshall University Joan C. Edwards School of MedicineAugust 2014 University of Mississippi Medical CenterAugust 2014 Central Region Case Western Reserve University School of Medicine*February 2014 Providence Hospital and Medical CenterMay 2014 (affiliated with St. Johns Health System) University of Kansas Medical Center**September 2013 University of Michigan Medical School October 2014 University of Minnesota Medical School* September 2014 Western Region University of California, San Francisco School of Medicine January 2015 * Te4Q Partner Sites**Te4Q Pilot

~30 participants per site Total of >400 participants to date, including pilot site Roughly 300 projects, for example: Full curricular reform (UME, GME, faculty development) Development of experiential learning for students, residents Targeted interventions to improve sepsis, VTE management, readmissions Reformatting M&M conferences into systems-based experiences Dozens of Project Review Events completed (roughly 100 participant projects reviewed) Six certificates delivered Participant tracking:

2015 Confirmed Te4Q Sites (Phase 2*) 1.The Warren Alpert Medical School of Brown University 2.Duke University 3.Michigan State College of Osteopathic Medicine 4.University of New Mexico School of Medicine 5.University of Vermont College of Medicine 6.VA Nebraska – Western Iowa Health System 7.In the pipeline: Temple University University of Florida College of Medicine University of South Alabama plus others *Phase 2: more site engagement pre and post workshop; increased tailored experience to meet system and educational program needs; workbook

Integrating Quality Annual Meeting (IQ) Chicago O’Hare June Combination of keynote presentations, workshops, posters, many featuring resident projects and training programs Post-IQ workshop (June 23-13): regulatory and accreditation changes affecting GME and quality, focused on DIOs, program directors, others interested in residency education and faculty development