Measuring the continuous quality improvement orientation of medical education programs

2020 ◽  
Vol 33 (2) ◽  
pp. 158-171
Author(s):  
Danielle Blouin ◽  
Everett V. Smith
Keyword(s):  
Medical Education ◽  
Quality Improvement ◽  
Continuous Quality Improvement ◽  
Scale Model ◽  
Validity Evidence ◽  
Rasch Modeling ◽  
Questionnaire Data ◽  
Content Type ◽  
Continuous Quality ◽  
Interpretation Of Results

PurposeThere is a growing interest in applying continuous quality improvement (CQI) methodologies and tools to medical education contexts. One such tool, the “Are We Making Progress” questionnaire from the Malcolm Baldrige National Quality Award framework, adequately captures the dimensions critical for performance excellence and allows organizations to assess their performance and identify areas for improvement. Its results have been widely validated in business, education, and health care and might be applicable in medical education contexts. The measurement properties of the questionnaire data were analyzed using Rasch modeling to determine if validity evidence, based on Messick's framework, supports the interpretation of results in medical education contexts. Rasch modeling was performed since the questionnaire uses Likert-type scales whose estimates might not be amenable to parametric statistical analyses.Design/methodology/approachLeaders and teachers at 16 of the 17 Canadian medical schools were invited in 2015–2016 to complete the 40-item questionnaire. Data were analyzed using the ConQuest Rasch calibration program, rating scale model.Findings491 faculty members from 11 (69 percent) schools participated. A seven-dimensional, four-point response scale model better fit the data. Overall data fit to model requirements supported the use of person measures with parametric statistics. The structural, content, generalizability, and substantive validity evidence supported the interpretation of results in medical education contexts.Originality/valueFor the first time, the Baldrige questionnaire results were validated in medical education contexts. Medical education leaders are encouraged to serially use this questionnaire to measure progress on their school's CQI focus.

Continuous quality improvement in a Maltese hospital using logical framework analysis

2016 ◽  
Vol 30 (7) ◽  
pp. 1026-1046 ◽  
Author(s):  
Sandra C. Buttigieg ◽  
Dorothy Gauci ◽  
Prasanta Dey
Keyword(s):  
Quality Improvement ◽  
Continuous Quality Improvement ◽  
Tertiary Care ◽  
Psychiatric Ward ◽  
Care Hospital ◽  
Logical Framework ◽  
Framework Analysis ◽  
Content Type ◽  
Continuous Quality ◽  
Quality Issues

Purpose The purpose of this paper is to present the application of logical framework analysis (LFA) for implementing continuous quality improvement (CQI) across multiple settings in a tertiary care hospital. Design/methodology/approach This study adopts a multiple case study approach. LFA is implemented within three diverse settings, namely, intensive care unit, surgical ward, and acute in-patient psychiatric ward. First, problem trees are developed in order to determine the root causes of quality issues, specific to the three settings. Second, objective trees are formed suggesting solutions to the quality issues. Third, project plan template using logical framework (LOGFRAME) is created for each setting. Findings This study shows substantial improvement in quality across the three settings. LFA proved to be effective to analyse quality issues and suggest improvement measures objectively. Research limitations/implications This paper applies LFA in specific, albeit, diverse settings in one hospital. For validation purposes, it would be ideal to analyse in other settings within the same hospital, as well as in several hospitals. It also adopts a bottom-up approach when this can be triangulated with other sources of data. Practical implications LFA enables top management to obtain an integrated view of performance. It also provides a basis for further quantitative research on quality management through the identification of key performance indicators and facilitates the development of a business case for improvement. Originality/value LFA is a novel approach for the implementation of CQI programs. Although LFA has been used extensively for project development to source funds from development banks, its application in quality improvement within healthcare projects is scant.

Role of medical education in health care reform

1997 ◽  
Vol 87 (1) ◽  
pp. 2-5
Author(s):  
MA Caselli
Keyword(s):  
Health Care ◽  
Medical Education ◽  
Quality Improvement ◽  
Health Care Reform ◽  
Continuous Quality Improvement ◽  
Medical Profession ◽  
Medical Community ◽  
Continuous Quality

Health care reform will have great impact on the podiatric physician as the podiatric medical profession continues to integrate into the general medical community. The role of medical education in addressing five major issues that affect health care reform is explored. These issues include specialization, economics, continuous quality improvement, ethics, and fraud.

scholarly journals Quality culture in action for a respiratory course: A dynamic CQI process at an engineering based allopathic medical school

2021 ◽  
Vol 2 (2) ◽  
pp. 146-152
Author(s):  
Lidija Barbaric ◽  
◽  
Bailey MacInnis ◽  
Kashif A. Ahmad ◽  
◽  
...  
Keyword(s):  
Medical Education ◽  
Quality Improvement ◽  
Medical School ◽  
Student Satisfaction ◽  
Continuous Quality Improvement ◽  
Dynamic Feedback ◽  
Liaison Committee ◽  
Benchmark Data ◽  
Continuous Quality ◽  
Culture Of Quality

Carle Illinois College of Medicine (CIMED) opened its doors in 2018 as an allopathic medical school under provisional accreditation by the Liaison Committee of Medical Education (LCME) and in 2014, the LCME mandated that all U.S. medical schools implement the process of internal continuous quality improvement (CQI). Here, the authors take a retrospective look at how CIMED utilized frequent and granular student feedback to contribute to continuous quality improvement (CQI) during the school’s Respiratory course, by citing specific examples of changes and student satisfaction outcomes from the inaugural class (2018) to the second class (2019). The authors outline how this cycle of evaluation and action can effectively incorporate students into the CQI process to enhance student success via faculty-student partnership. Furthermore, the authors discuss the nuance of feedback interpretation by the involved faculty and advocate for CQI based on a deeper understanding of the student experience such that change initiated by CQI may extend beyond benchmark data collection. The authors discuss how dynamic feedback may be helpful in achieving equipoise between long-standing principles of medical pedagogy and newer trends in medical education, while still maintaining student satisfaction and continuing to develop a culture of quality improvement.

scholarly journals Fostering trust, collaboration, and a culture of continuous quality improvement: A call for transparency in medical school accreditation

2020 ◽  
Author(s):  
Arshia Javidan ◽  
Lucshman Raveendran ◽  
Yeshith Rai ◽  
Sean Tackett ◽  
Kulamakan Mahan Kulasegaram ◽  
...  
Keyword(s):  
Medical Education ◽  
Quality Improvement ◽  
Continuous Quality Improvement ◽  
North American ◽  
Professional Training ◽  
Medical Schools ◽  
Public Reporting ◽  
Educational Process ◽  
The Public ◽  
Continuous Quality

Medical schools provide the foundation for a physician’s growth and lifelong learning. They also require a large share of government resources. As such, they should seek opportunities to maintain trust from the public, their students, faculty, universities, regulatory colleges, and each other. The accreditation of medical schools attempts to assure stakeholders that the educational process conforms to appropriate standards and thus can be trusted. However, accreditation processes are poorly understood and the basis for accrediting authorities’ decisions are often opaque.  We propose that increasing transparency in accreditation could enhance trust in the institutions that produce society’s physicians. While public reporting of accreditation results has been established in other jurisdictions, such as Australia and the United Kingdom, North American accrediting bodies have not yet embraced this more transparent approach. Public reporting can enhance public trust and engagement, hold medical schools accountable for continuous quality improvement, and can catalyze a culture of collaboration within the broader medical education ecosystem. Inviting patients and the public to peer into one of the most formative and fundamental parts of their physicians’ professional training is a powerful tool for stakeholder and public engagement that the North American medical education community at large has yet to use.

scholarly journals Importance of Quality in Medical and Dental Institutes

2019 ◽  
Vol 09 (02) ◽  
pp. 159-161
Author(s):  
Kiran Fatima Mehboob Ali Bana
Keyword(s):  
Medical Education ◽  
Quality Improvement ◽  
Patient Care ◽  
Continuous Quality Improvement ◽  
International Standards ◽  
Accreditation Council ◽  
Continuous Quality ◽  
The World ◽  
Optimal Patient Care ◽  
Improvement Measures

There is a dire need to incorporate quality improvement measures in medical education of our country as now worldwide the paradigm is shifted from the students’ outcome to the continuous quality improvement (CQI) measures. The ultimate goal of CQI is to provide optimal patient care. This is the responsibility of the accreditation council (PMDC) to ensure the true application of quality improvement indicators in medical institutes. The quality document introduced by the PMDC is the true reflection of the world accreditation bodies WFME, WHO. By ensuring the true application of this quality document, Pakistan Medical and Dental Council will be able to compete with the International standards of medical education through competent future physicians.

scholarly journals Evaluation of continuous quality improvement in accreditation for medical education

2020 ◽  
Vol 20 (S1) ◽  
Author(s):  
Nesibe Akdemir ◽  
Linda N. Peterson ◽  
Craig M. Campbell ◽  
Fedde Scheele
Keyword(s):  
Medical Education ◽  
Quality Improvement ◽  
Continuous Quality Improvement ◽  
Early Warning Systems ◽  
Governance Structure ◽  
The Public ◽  
Positive Effects ◽  
Continuous Quality ◽  
Pros And Cons ◽  
Toxic Culture

Abstract Background Accreditation systems are based on a number of principles and purposes that vary across jurisdictions. Decision making about accreditation governance suffers from a paucity of evidence. This paper evaluates the pros and cons of continuous quality improvement (CQI) within educational institutions that have traditionally been accredited based on episodic evaluation by external reviewers. Methods A naturalistic utility-focused evaluation was performed. Seven criteria, each relevant to government oversight, were used to evaluate the pros and cons of the use of CQI in three medical school accreditation systems across the continuum of medical education. The authors, all involved in the governance of accreditation, iteratively discussed CQI in their medical education contexts in light of the seven criteria until consensus was reached about general patterns. Results Because institutional CQI makes use of early warning systems, it may enhance the reflective function of accreditation. In the three medical accreditation systems examined, external accreditors lacked the ability to respond quickly to local events or societal developments. There is a potential role for CQI in safeguarding the public interest. Moreover, the central governance structure of accreditation may benefit from decentralized CQI. However, CQI has weaknesses with respect to impartiality, independence, and public accountability, as well as with the ability to balance expectations with capacity. Conclusion CQI, as evaluated with the seven criteria of oversight, has pros and cons. Its use still depends on the balance between the expected positive effects—especially increased reflection and faster response to important issues—versus the potential impediments. A toxic culture that affects impartiality and independence, as well as the need to invest in bureaucratic systems may make in impractical for some institutions to undertake CQI.

scholarly journals A systematic review on the effectiveness of clinician directed interventions to improve compliance to post polypectomy surveillance guidelines

2021 ◽  
Author(s):  
Tak Loon Khong ◽  
Xin-Hui Khoo ◽  
Ida Hilmi
Keyword(s):  
Medical Education ◽  
Quality Improvement ◽  
Decision Support ◽  
Clinical Decision Support ◽  
Continuous Quality Improvement ◽  
Clinical Decision Support Systems ◽  
Clinical Decision ◽  
Specialist Nurse ◽  
Continuous Quality ◽  
Colonoscopy Surveillance

Introduction Clinical practice guidelines recommend periodic colonoscopy surveillance following colorectal adenoma excision. Inappropriate use of post polypectomy surveillance is common and lead to improper resource utilisation.The aim of this review is to identify structured interventions which can affect post polypectomy surveillance practices and to evaluate the effectiveness of these various interventions in improving clinician adherence to post polypectomy surveillance guidelines. Methods A computerised search was performed to identify relevant studies between 1997 to November 2020. Two investigators identified eligible studies and extracted data independently. The quality of the included studies was assessed by the Newcastle-Ottawa risk of assessment scoring system. Results The search identified 5602 citations. Forty-one articles were retrieved for full text analysis and seven studies met the inclusion criteria. Compliance to PPS guidelines were higher following interventions which included medical education, specialist nurse coordinators facilitation, continuous quality improvement and clinical decision support systems. Conclusion This study demonstrates that medical education, specialist nurse coordinators, continuous quality improvement and clinical decision support systems are effective in improving clinicians’ compliance to post polypectomy surveillance guidelines and is associated with reduction in over- and underutilisation of colonoscopy surveillance resources.

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