1. QI & Patient Safety Update
Department of Medicine
Unit Directors Meeting
May 23, 2016

2. Agenda Department QI and Patient Safety Goals QA&I Committee Update
FY2017 UVMMG Quality Metricss
Shameless Plugs:
Biostats support
High value care proposals
Future Website Content

3. QI Goals for Dept of Medicine
Create infrastructure and resources within the department to support scholarly QI activities
Develop faculty skills in QI methodology and cultivate a cadre of faculty experts in QI
Enhance innovation and scholarly productivity in QI and high value care
Align and promote collaboration in QI efforts across divisions

4. Medicine QA&I Committee
Group
Member
Administration
Allen Mead
Cardiovascular Medicine
Dr. Mark Capeless transitioning to Dr. Peter Van Buren
Chief Residents
Dr. Jon Halevy
Dermatology
Dr. Julie Lin
Endocrinology
Ann Gotham, ANP
Fellows
Drs. Krysti Spiess (ID), Patrick Hohl (Cards), Sean McMahon (Cards)
Gastroenterology
Dr. Jim Vecchio
General Internal Medicine + Geriatrics
Dr. Marie Sandoval
Hematology/Oncology
Dr. Farrah Khan
Hospital Medicine
Dr. Mike Latreille
Infectious Disease
Dr. Mary Ramundo
Jeffords Institute for Quality
Pam Stevens, RN
Nephrology
Dr. Jeff Rimmer
Nursing
Tammy Berrings, RN (B4), Susan Bellemare, RN (M5), Peg Gagne, RN
Patient representative
Walter Grant
Pharmacy
Maria Airoldi, RPh
PRISM
ad hoc
Pulmonary Disease & Critical Care
Dr. Yolanda Mageto & Dr. Gil Allen
Residents
Dr. Susanna Thach
Rheumatology & Clinical Immunology
Amanda Kennedy, PharmD

5. Medicine QA&I Committee
“Usual” activities
Case reviews
Adverse events, mortalities
Reports on institutional initiatives
Patient experience, length of stay, core measures, mortality
Specific institutional or department initiatives
e.g., sepsis

6. Medicine QA&I Committee
New Activities
Forum for review UVMMG Quality Metrics
Engage divisional representatives in process of developing
Develop “themes” to align UVMMG quality metrics
Monitor progress, ensure timely submission
Identify need for support (e.g., baseline performance, ongoing reporting)
Defining specific metrics still up to individual divisions
Divisional reports
Divisional presentations about QI and patient safety activities within division
High value care projects – adjudication of proposals

8. UVMMG FY2017 Metrics Medicine QA&I Committee
Generated approximately 30 potential “themes” - broad categories to align the FY2017 QI initiatives across divisions
Factors: current QI initiatives, UVMMC strategic goals, cross-divisional, measurable, meaningful
Identified 3 themes:
Transitions of Care
Advance Care Planning
Patient Experience

9. UVMMG Quality Metrics - Considerations
Two measurement periods
Measurement Period 1: October 1, March 31, 2017
Measurement Period 2: April 1, September 30, 2017
SMART Criteria:
Specific
Measurable
Attainable
Relevant
Time bound
Can build on current initiatives
Requires “active participation by physicians”
Requires achievement of target performance (not just documentation of participation)
No such thing as perfect

10. Shameless Plug #1: Biostats
Initial funding for 100 hours of biostats
Focus = scholarly QI projects led by junior faculty as well as mentored resident and fellow QI projects
Application process
Simple, 1 page (handout)
Compels consideration of key elements for project
Identifies scholarly product
Submission to yours truly. Review by Renee Stapleton and me.
Based on initial demand, will determine need for dedicated %FTE for biostats

11. Shameless Plug #2: High Value Care
Seeking next round of HVC proposals
Program entering its 5th year  14 projects undertaken
Projects focus on: reducing harm, reducing cost and/or improving patient outcomes or experience
1 page application – recently circulated via
Evaluated on a rolling basis 
Selected projects receive:
Project Management for Jeffords Institute for Quality
Data analytics from Jeffords including collecting background and follow up information (no second application needed)
Resources from the clinical steering committee to develop a system change, including PRISM alterations

12. Future Website Content
List of divisional QI and Patient Safety activities
Application for biostats support
High Value Care proposal form
“Guide to QI” in Department of Medicine
Faculty development and publishing resources