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Teaching QI to radiology residents and faculty

Teaching QI to radiology residents and faculty. Nadja Kadom, M.D . BMC, Department of Radiology, Boston MA Karin Sloan, M.D. BMC, Department of Internal Medicine, Boston MA Gouri Gupte , Ph.D. Boston University School of Public Health, Boston MA

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Teaching QI to radiology residents and faculty

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  1. Teaching QI to radiology residents and faculty Nadja Kadom, M.D. BMC, Department of Radiology, Boston MA Karin Sloan, M.D. BMC, Department of Internal Medicine, Boston MA GouriGupte, Ph.D. Boston University School of Public Health, Boston MA James Moses, M.D. BMC, department of Pediatrics, Boston MA

  2. Disclosures • No financial interests.

  3. Abstract • A quality improvements (QI) curriculum was developed at Boston Medical Center, as a novel means to enable residents in radiology to perform QI projects using the Plan Do Study Act-cycle method. • While few such radiology residency programs exist elsewhere, this is the first with built-in faculty mentorship, thereby allowing radiology faculty to learn about QI in their function as mentors and fulfill their own requirements of maintaining radiology certification. • One of the key barriers identified in the literature to successful resident QI curricula and projects is a lack of faculty mentorship. By linking the curriculum for residents to building faculty mentorship capacity, we are innovatively addressing this important barrier. This model of teaching QI is generalizable across many disciplines.

  4. Background • Mann KJ, Craig MS, Moses JM. Quality improvement educational practices in pediatric residency programs: survey of pediatric program directors. AcadPediatr. 2014 Jan-Feb;14(1):23-8.

  5. 2013

  6. Curriculum Design Sequence Why do we need this curriculum? Publishers: Jossey-Bass (July 21, 2008) ISBN-10: 047026134X

  7. QI Needs • Our duty to patients, ethics Primum non nocere First, Do No Harm Hippocrates 98,000 Death/Year in U.S. from medical injuries IOM 1999

  8. QI Needs • Translational gap

  9. QI Needs • Licensure, Certification, Accreditation National Patient Safety Goals Competency “Systems-Based Practice” Standardized use of technology/technique MOC, part IV

  10. QI Needs • Reimbursements 2001 IOM 2001 • Physician Quality Reporting System (PQRS) • Pay-for-performance (P4P, value-based purchasing)

  11. Curriculum Design Sequence What is the gap we will close with this curriculum?

  12. Goals & objectives How they get there

  13. Trainees & Faculty No QI experience Completed QI project How they get there

  14. Goals • Objectives- How they get there

  15. No QI experience Completed QI project On your feet, look up! Faculty

  16. Basics Curriculum Design Sequence How exactly will we deliver and assess learning?

  17. Design • Instruction • Assessment learners & course

  18. Design • Instruction • Assessment learners & course

  19. Design • Instruction • Assessment learners & course Lectures, Journal club

  20. Design • Instruction • Assessment learners & course Deliverables on a timeline

  21. September QI resident presentations March QI JC March-June PDSA cycle August-November QI lectures December Teams & topics January-February Prediction & Baseline July 1st New residents June 30 Project completion • 3 lectures • Noon lectures • 60 minutes • Radiology conference room • Guest speakers • Topics • Aim statement • Team leader, members • Prediction • Measures • Baseline • Fishbone etc. • Run chart • Goal line • Interventions • Observations Lectures “Deliverables”

  22. Basics Curriculum Design Sequence How will this be executed?

  23. Lectures, JC Deliverables • Support, buy-in • Scheduling problems • Attendance problems • Access to resources • Time to prepare • Process for delivery • Process to check submitted • Process to check complete • Process to check correct Execution • Implementation

  24. Basics Curriculum Design Sequence Did the curriculum reach the goal?

  25. Learner Curriculum Knowledge Skills Attitudes EVERY aspect Every single…. Open comments Revision • As indicated by assessments

  26. Results • All (eligible) residents enrolled (n=30/39) • 16 projects • 10/21 faculty serve as mentors • Pre-test: 98% response rate 55% residents 45% faculty

  27. Results Pre:

  28. Summary Why do we need this curriculum? What is the gap we will close with this curriculum? How will we facilitate and assess learning? What will the teaching schedule be? Did the curriculum reach the goal?

  29. nkpiano@gmail.com Thanks to: Stephanie Coleman and Louis Golden, BMC residents BMC Education Committee: Avneesh Gupta, Kitt Shaeffer Chairman: Alex Norbash BMC Karin Sloan, Director of Clinical Quality, Department of Medicine BMC James Moses, Medical Director of Quality Improvement, Department of Pediatrics BU School of Public Health, Gouri Gupte, Health Policy & Management Thank you.

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