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A Collaborative Quality Improvement Curriculum for Internal Medicine Residents and Masters of Public Health Students: The Lean Way Gouri Gupte PhD, School.

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Presentation on theme: "A Collaborative Quality Improvement Curriculum for Internal Medicine Residents and Masters of Public Health Students: The Lean Way Gouri Gupte PhD, School."— Presentation transcript:

1 A Collaborative Quality Improvement Curriculum for Internal Medicine Residents and Masters of Public Health Students: The Lean Way Gouri Gupte PhD, School of Public Health Charlene Weigel MD, Department of Medicine, Mount Auburn Hospital Winnie Suen MD, MSc, Department of Internal Medicine, Section of Geriatrics, Boston Medical Center Gouri Gupte PhD, School of Public Health Charlene Weigel MD, Department of Medicine, Mount Auburn Hospital Winnie Suen MD, MSc, Department of Internal Medicine, Section of Geriatrics, Boston Medical Center

2 Exercise: Step 1: Please watch the video Step 2: Please arrange the index cards (steps) in chronological order Step 2: Identify those steps that are not necessary to the process. Step 1: Please watch the video Step 2: Please arrange the index cards (steps) in chronological order Step 2: Identify those steps that are not necessary to the process.

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4 GOALS COMPETENCIES MET Improve the quality and cost- effectiveness of healthcare delivery and QI education in multiple clinical microsystems at BMC Systems-based practice - Learner will gain an appreciation of the complex system of health care and how to approach improving one piece of it. Practice-based learning and improvement - Leaner will use self-reflection of their own practice in order to use this as a way to make improvements Use Lean methodology principles to create a Quality Improvement curriculum for interdisciplinary teams. Systems-based practice - Learner will gain knowledge about Lean Methodology, creation of process flow chart, how to identify ways to improve a system Interpersonal and Communication Skills - Leaner will gain skills in working with an interdisciplinary team. Combine with MPH students Professionalism - Learner will be accountable to and work effectively with teams - Learners will respect the interdisciplinary staff that they will be working with to gain hands on experience in a QI project

5 Residents at Boston Medical Center (Clinical Knowledge) Public Health Students at Boston University (Quality improvement consultants)

6 Schedule

7 Session 1: Intro to QI at BMC

8 Session1 cont ’ d: 4 pods x4 groups = 16 projects

9 Projects: Identified by the students Outpatient Medication Review Inpatient Medication Review Seeing patients efficiently in clinics Patient awareness of members of the inpatient team (improved patient satisfaction) Eliminate number paging Improving resident-nursing communication Improving inpatient workflow Improving team roles in Emergency response team Improving notification of when labs aren ’ t drawn Improving prerounding experience Improving missed appointments Discharge appointment process Outpatient Medication Review Inpatient Medication Review Seeing patients efficiently in clinics Patient awareness of members of the inpatient team (improved patient satisfaction) Eliminate number paging Improving resident-nursing communication Improving inpatient workflow Improving team roles in Emergency response team Improving notification of when labs aren ’ t drawn Improving prerounding experience Improving missed appointments Discharge appointment process

10 Session 2: Process Mapping

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12 Session 3 & 4 Session 3: Identifying Wastes and Inefficiencies Session 4: Presentations, Recommendations, Judges/Prizes Session 3: Identifying Wastes and Inefficiencies Session 4: Presentations, Recommendations, Judges/Prizes

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15 Challenges: For the residents TIME, TIME AND TIME Too many systems involved Very complex subject Resistance to change TIME, TIME AND TIME Too many systems involved Very complex subject Resistance to change

16 Challenges: For Public Health students Lack of QI knowledge among residents Lack of awareness about systems thinking amongst residents Lack of time to work on QI projects Priority issues Lack of urgency for the project Lack of QI knowledge among residents Lack of awareness about systems thinking amongst residents Lack of time to work on QI projects Priority issues Lack of urgency for the project

17 Challenges: For us No administrative support No funding support Difficult to find mentors Lack of sponsorship for the projects Limited time line No administrative support No funding support Difficult to find mentors Lack of sponsorship for the projects Limited time line

18 Main learning points for the Residents and Students QI projects are time intensive There are simple, cost-effective solutions for frustrating problems We can change the system in a systematic way and not just whining Small steps can make a difference in overall process QI projects are time intensive There are simple, cost-effective solutions for frustrating problems We can change the system in a systematic way and not just whining Small steps can make a difference in overall process

19 Final presentation

20 Next Steps… Further implementation and expansion of current curriculum Collaboration with other schools and students More mentors Longer duration program Taking the show on the road Further implementation and expansion of current curriculum Collaboration with other schools and students More mentors Longer duration program Taking the show on the road

21 Questions? Resources: Resources:

22 A Collaborative Quality Improvement Curriculum for Internal Medicine Residents and Masters of Public Health Students: The Lean Way Gouri Gupte PhD, School of Public Health, Charlene Weigel MD, Department of Medicine, Mount Auburn Hospital, Winnie Suen MD, MSc, Department of Internal Medicine, Section of Geriatrics, Boston Medical Center, Gouri Gupte PhD, School of Public Health, Charlene Weigel MD, Department of Medicine, Mount Auburn Hospital, Winnie Suen MD, MSc, Department of Internal Medicine, Section of Geriatrics, Boston Medical Center,


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