Residents contributing to inpatient quality: blending learning and improvement.
J Hosp Med
; 7(2): 148-53, 2012 Feb.
Article
en En
| MEDLINE
| ID: mdl-22086474
ABSTRACT
BACKGROUND:
Quality improvement (QI) initiatives reduce medical errors and are an important aspect of resident physician training. Many institutions have limited funding and few QI experts, making it essential to develop effective programs that require only modest resources. We describe a resident-led, hospitalist-facilitated limited root cause analysis (RCA) QI program developed to meet training needs and institutional constraints.METHODS:
We initiated a monthly quality improvement conference (QIC) at the Mount Sinai Hospital in New York City, New York. Before each conference, a third-year resident investigated a patient care issue and completed a limited RCA. At the QIC, the findings were presented to the Internal Medicine residents, followed by a chief resident and hospitalist-facilitated group discussion. All proposed interventions were recorded, and selected interventions were later implemented. The success of these interventions in achieving permanent system-wide change or resident behavior change was tracked. Residents' views on the conferences were solicited via an anonymous questionnaire.RESULTS:
Twenty conferences were held over the first 22 months of the program. Twenty-five (54%) of the 46 suggested interventions were initiated. Eighteen (72%) attempted interventions resulted in system-wide change or resident behavior change. Fifty-three residents evaluated the quality of the conferences. The majority believed the conferences were high quality (98%) and led to patient care improvements (96%).CONCLUSIONS:
Resident-led modified RCAs are an effective method of integrating QI efforts into resident training. As front line providers, residents are uniquely positioned to identify and implement system changes that benefit patients. Conferences were implemented without overburdening facilitators or participants.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Calidad de la Atención de Salud
/
Mejoramiento de la Calidad
/
Análisis de Causa Raíz
/
Pacientes Internos
/
Internado y Residencia
/
Aprendizaje
Tipo de estudio:
Prognostic_studies
Límite:
Humans
Idioma:
En
Revista:
J Hosp Med
Año:
2012
Tipo del documento:
Article
País de afiliación:
Estados Unidos