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• W2898876419 abstract "To the Editor: Dr. Butler and colleagues1 provide a much-needed scientific examination of a phenomenon that many of us in graduate medical education (GME) have experienced anecdotally. Residents often perceive quality improvement (QI) as a silo within health care rather than as integral to ongoing high-quality patient care. The authors point out that, to further the development of learning related to health care systems, it is crucial for residents to adopt QI values. We agree and offer three suggestions to address this perceived conflict between QI and patient care. Select projects that matter to residents. Metrics such as length of stay or discharges by noon, while vital at the institutional level, may not correlate directly to high-quality care in the eyes of residents. However, as frontline providers, residents often have insight into quality and safety issues that have not yet attracted hospital-wide attention. Gaining insight from residents’ concerns and designing improvement work to address them can lead to better engagement. Involve more faculty in the work. We believe that throughout medical education, learning that directly relates to patient care is what matters most to trainees. If residents do not hear their attendings explicitly address QI and patient safety on rounds or see them at project planning meetings, they are likely to view these activities as “extra” work, separate from clinical care. While training faculty in QI methods may be out of scope for many GME programs, one strategy is to invite them to specific QI project sessions where experiential learning occurs. This so-called “co-learning” strategy has been previously described and can help bring awareness to the residents’ efforts, while simultaneously educating and engaging an important set of stakeholders.2 Consider design thinking methods. A variety of QI methods such as Lean Six Sigma and the Model for Improvement have gained traction in GME over the past decade. We encourage QI educators to consider adding perspectives from design thinking. Many of its tenets (e.g., focusing on human values, empathic inquiry, multidisciplinary collaboration) directly mirror those of good patient care and can help further blend QI with clinical work.3 QI curricula are designed to produce physicians who understand and value the principles of continuous QI throughout their career and see this work as part of their professional identity as opposed to “a lot of extra work.” We thank Dr. Butler and colleagues for this important first step in examining our current trajectory toward that goal. As the first generation of QI curricula for residents matures, we must continue this examination. Ryan Buckley, MDAssistant professor of clinical medicine, Section of Hospital Medicine, Division of General Internal Medicine, Department of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; [email protected] Morgan Sellers, MDResident physician, Department of Surgery, University of Pennsylvania, Philadelphia, Pennsylvania. Jennifer Myers, MDProfessor of clinical medicine, Section of Hospital Medicine, Division of General Internal Medicine, Department of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania." @default.
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• W2898876419 date "2018-11-01" @default.
• W2898876419 modified "2023-10-16" @default.
• W2898876419 title "Blurring the Perceived Lines Between Clinical and Quality Improvement Education" @default.
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• W2898876419 doi "https://doi.org/10.1097/acm.0000000000002417" @default.
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