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
The clinical
care gap
2) The National view:
Dartmouth Atlas 2010 - 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)
Teaching for Quality (Te4Q)
 A consultative service focused
on organizational and
educational methods to improve
quality
 Initiated 2012
 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
M&M Conferences – MM&I
•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
•Use systems-based approach
•Review several or more cases, deemphasizing 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
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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 2013-2014 (Phase 1)
Northeast Region
Geisinger Health System*
Jefferson School of Population Health
Workshops held
April 2014
November 2014
(affiliated with The Sidney Kimmel Medical College at Thomas Jefferson University)
North Shore Long Island Jewish Health System
Stony Brook University School of Medicine
University of Rochester School of Medicine and Dentistry
Southern Region
Marshall University Joan C. Edwards School of Medicine
University of Mississippi Medical Center
Central Region
Case Western Reserve University School of Medicine*
Providence Hospital and Medical Center
(affiliated with St. Johns Health System)
University of Kansas Medical Center
**
University of Michigan Medical School
University of Minnesota Medical School*
Western Region
September 2014
December 2014
October 2014
University of California, San Francisco School of Medicine
January 2015
*Te4Q Partner Sites
**Te4Q Pilot
August 2014
August 2014
February 2014
May 2014
September 2013
October 2014
September 2014
Participant tracking: 2013-2014
• ~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
2015 Confirmed Te4Q Sites (Phase 2*)
1.
2.
3.
4.
5.
6.
7.
The Warren Alpert Medical School of Brown University
Duke University
Michigan State College of Osteopathic Medicine
University of New Mexico School of Medicine
University of Vermont College of Medicine
VA Nebraska – Western Iowa Health System
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
www.aamc.org/ae4Q
www.aamc.org/te4Q
Integrating Quality Annual Meeting (IQ)
• Chicago O’Hare
• June 11-12 2015
• 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
www.aamc.org/meetings