IHI Open School Quality Improvement/Patient Safety The IHI Student Consortium

IHI Open School The Quality Project Presented by the IHI Student Consortium The Quality Project is a collaboration among preclinical and clinical students, residents, fellows, faculty, and administrators across Stanford. Our mission is to develop higher quality healthcare that is more safe, effective, patient-centered, timely, efficient, and equitable through education, research, advocacy, and implementation.

IHI Open School IHI Student Consortium EducationResearchAdvocacyImplementation

IHI Open School EducationResearchAdvocacyImplementation - Leadership Course - QI Lecture Series - QI Clinical Elective - QI in Q6 - Med-Scholars - Internal Medicine Program - Hand Hygiene Project - Leadership Training in Medicine - Global Safe Surgery Mentor Project - Patient-Centered Care in Fellowship - CBEI & Quality - Team Easy - Hospital Management Collaborative - Hand Hygiene: Implementation - Pacific Free Clinic Quality Initiative

IHI Open School Medical Leadership Development Matthew Goldstein, SMS VI Robin Eisenhut, SMS III Barnard Palmer, MD Tiffany Castillo, SMS V

IHI Open School  Initiated in 2008 PEDS 201: 1 unit, Fall Quarter Course Director: Charles Prober Facilitator: Julia Tussing  Students:  Received 40 applications for 8 medical student spots  8 Medical Students (Years 1-3)  4 Chief Residents (Medicine, Surgery, Pediatrics, Psychiatry)  Topics:  What is Leadership?  Self-Knowledge  Communication & Emotional Intelligence  Conflict Management  Influence  Effective Teams Leadership Training in Medicine

IHI Open School As a leader I… …encourage everyone to speak their mind**P =.0082 …ask you to take positions that support your core values * P = …seek feedback to improve interactions with others **P = …show that I understand how specific actions impact others *P = Conflict Management I am capable of giving constructive feedback*P = Self-Awareness I have a deep understanding of my strengths, weaknesses, needs, and drives. *P = I am honest with myself. *P = I undertake realistic self-assessment. **P =

IHI Open School Testamonial: Would you recommend the MLD course to others? Do you believe leadership skills should be taught to medical professionals? “Yes and yes. I believe leadership skills are learned, and for those who have access to those skills it is a great benefit. As someone who does not have family in the medical field, it was invaluable to hear the stories of some leaders in the field and reflect on and discuss many aspects of leadership that will serve me well as I progress through training and in shaping my career.” “Yes, and YES! Simply talking about it prompts reflection, and makes each of us better leaders. This course coincided with a lot of challenging situations in my own academic/work life, and it was a great compliment to my own personal development since it forced me to take some time and just think. I also think it is important for students to see leaders who did not necessarily know which way was up at some point in their lives. In this way the course also foster humanity and humanism, and we cannot be doctors without that.” “YES YES YES. Leadership skills should def be taught to medical professionals. MDs are kind, hard working, compassionate individuals but sometimes in my experience I have seen that they do not take charge and try to make a change as much as their skills should allow them to.”

IHI Open School Future Iterations… The Ideal:  full-year, independent course  integrated into curriculum  more of a t-group model  inter-disciplinary effort between GSB and SoM  mandatory for all students The Reality:  insert or piggy-back on select components in existing curricula if all students are to be exposed  continue to offer an elective or encourage students to utilize GSB/VPGE leadership courses

IHI Open School Internal Medicine QI Elective & A Hand Hygiene Project Kambria Hooper, M.Ed. Stephanie Carr, SMS III

IHI Open School Internal Medicine QI Elective  Initiated in 2010 MED 344A: 6 unit, Any Quarter Course Director: Clarence Braddock  Topics:  Mentored practice and growth in knowledge, skills, and attitudes in quality improvement, patient safety, and organizational change  Directed readings, attend sessions with experienced QI champions  Learn about quality improvement projects and processes at Stanford University  Participate in ongoing quality and patient safety activities within the Department of Medicine and Stanford Hospital and Clinics  Design and begin a quality improvement/patient safety/organizational change project  Develop a mentoring relationship with a QI champion who will serve as a role model, mentor, and educator

IHI Open School Stephanie Carr: Hand Hygiene – Follow the Leader?  Hypothesis:  To determine whether the hand hygiene habits of attending physicians or the first person entering/exiting the patient room influenced the compliance of other physician team members.  Method:  Four medical students individually shadowed physician teams during morning rounds and measured hand hygiene compliance  Results:  Physician team members were more likely to wash their hands upon entering and exiting patient rooms if their attendings washed (75% v. 29%; p < 0.001)  Team members were also more likely to wash if the first person entering/exiting washed (75% v. 31%; p < 0.001)  Conclusion:  Efforts to improve hand hygiene compliance should be directed towards the attendings.

IHI Open School Team Easy: Incorporating Quality Improvement (QI) into Stanford Medical Curricula Shubha Bhat, SMS II Natalia Leva, SMS II Felipe Perez, SMS II Julia Pederson, SMS II Stephanie Smith, SMS II

IHI Open School Team EASY: advocacy project Goal: Incorporate QI training into longitudinal medical curriculum Process: Needs assessment with stakeholders Outcomes: –“QI in Q6" pilot project, June 2010 –Recommendations for QI Core Competencies –CCAP working group formed Next steps: –Build support and interest among students and faculty –Develop, pilot, and implement QI curriculum

IHI Open School Team Easy Advocacy Project

IHI Open School Team Easy: Stanford QI Training Environment

IHI Open School

The Hospital Management Collaborative Promoting Patient Safety Entrepreneurship Nirav Kamdar, MD MPP Department of Internal Medicine

IHI Open School HMC Class IHI Breakthrough Projects QI Resident Elective QI Team Challenge Clinical Effectiveness CERC Quality Working Groups Quality Council QIPSC EducationSOM Centers

IHI Open School  Create a health system modeling pipeline  Provide access to primary data  Provide exposure to real health management problems  Provide a client experience with support  Increase academic leadership in quality improvement  Increase resident publication opportunities HMC: Goals

IHI Open School HMC: What we need…  Single roundtable meeting with multidisciplinary faculty  Direct interaction with CERC’s strategic plan  Organizational personnel to develop HMC course and coordinate project teams

IHI Open School Conclusions

IHI Open School  Align student initiatives with faculty/administration projects already underway  Help facilitate a round table meeting with multidisciplinary faculty and students*  Provide students with opportunities for internships, rotations, and research in the QI/PS space  Incorporate quality improvement and patient safety as a core competency throughout undergraduate and graduate medical education Conclusions