scholarly journals Ongoing Self-review and Continuous Quality Improvement Among Family Medicine Residencies

2021 ◽  
Author(s):  
Peter J. Carek ◽  
Stacy E. Potts
Keyword(s):  
Quality Improvement ◽  
Family Medicine ◽  
Patient Care ◽  
Role Models ◽  
Program Improvement ◽  
Training Environment ◽  
Community Activities ◽  
Continuous Quality ◽  
Optimal Patient Care ◽  
Future Practice

Graduate medical education (GME) occurs during and is a crucial step of the transition between medical school and clinical practice. Residency program graduates’ abilities to provide optimal patient care, act as role models, and demonstrate excellence, compassion, professionalism, and scholarship are key elements and outcomes of successful GME programs. In order to create and maintain the training environment that leads to such outcomes, programs must continually review and revise their patient care and educational activities. Currently, compliance with accreditation standards as determined by individual specialties such as family medicine serves as a common and significant marker for program quality. Compliance with these requirements is necessary but not sufficient if faculty and residents want to achieve the goal of residency training in terms continually improving and optimizing the care they provide to their patients and communities. For overall program improvement to truly occur, the patient care, scholarship, and community activities of current residents and graduates must be assessed and used in program improvement activities. Appropriately applied to programs and using these assessments, quality improvement principles and tools have the potential to improve outcomes of patient care in residents’ current and future practice and improve programs in educating residents.

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 The Residency Performance Index: An Effort at Residency Quality Assessment and Improvement in Family Medicine

2014 ◽  
Vol 6 (4) ◽  
pp. 756-759 ◽  
Author(s):  
Grant S. Hoekzema ◽  
Lisa Maxwell ◽  
Joseph W. Gravel ◽  
Walter W. Mills ◽  
William Geiger
Keyword(s):  
Quality Improvement ◽  
Family Medicine ◽  
Performance Index ◽  
Program Improvement ◽  
First Year ◽  
Clinical Experiences ◽  
Residency Programs ◽  
Family Medicine Residency ◽  
Lack Of Information ◽  
Quality Improvement Tool

Abstract Background Residency programs are increasingly being asked to defend their quality, and that of the residents they produce. Yet “residency quality” is a construct that has not been well defined, with no accepted standards other than meeting accreditation standards. In 2009, the Association of Family Medicine Residency Directors developed a strategic plan that included the goal of raising the quality of family medicine training. Objective We describe the development of this quality improvement tool, which we called the residency performance index (RPI), and its first year of use by family medicine residency programs. We describe the use of the tool as a “dashboard” to facilitate program self-improvement. Intervention Using program metrics specific to family medicine training, and benchmark criteria for these metrics, the RPI was launched in 2012 to help programs identify strengths and areas for improvement in their educational activities and resident clinical experiences that could be tracked and reviewed as part of the annual program evaluation. Results Approximately 100 program directors began using the tool and 70 finished the process, and were provided aggregate data. Initial review of this experience revealed difficulties with collecting data, and lack of information on graduates' scope of practice. It also showed the potential usefulness of the tool as a program improvement mechanism. Conclusions The RPI is a new quality improvement tool for family medicine residency programs. Although some initial challenges need to be addressed, it has the promise to aid family medicine residency in its internal improvement efforts.

scholarly journals Education in Quality Improvement for Practice in Primary Care During Residency Training and Subsequent Activities in Practice

2014 ◽  
Vol 6 (1) ◽  
pp. 50-54 ◽  
Author(s):  
Peter J. Carek ◽  
Lori M. Dickerson ◽  
Michele Stanek ◽  
Charles Carter ◽  
Mark T. Godenick ◽  
...  
Keyword(s):  
South Carolina ◽  
Quality Improvement ◽  
Family Medicine ◽  
Patient Care ◽  
Patient Centered ◽  
Residency Programs ◽  
Family Medicine Residency ◽  
The Family ◽  
The Impact ◽  
Standardized Curriculum

Abstract Background Quality improvement (QI) is an integral aspect of graduate medical education and an important competence for physicians. Objective We examined the QI activities of recent family medicine residency graduates and whether a standardized curriculum in QI during residency resulted in greater self-reported participation in QI activities in practice after graduation. Methods The family medicine residency programs affiliated with the South Carolina Area Health Education Consortium (N  =  7) were invited to participate in this study. Following completion of introductory educational activities, each site implemented regularly occurring (at least monthly) educational and patient care activities using QI principles and tools. Semiannually, representatives from each participating site met to review project aims and to provide updates regarding the QI activities in their program. To examine the impact of this project on QI activities, we surveyed graduates from participating programs from the year prior to and 2 years after the implementation of the curriculum. Results Graduates in the preimplementation and postimplementation cohorts reported participating in periodic patient care data review, patient care registries, QI projects, and disease-specific activities (57%–71% and 54%–63%, respectively). There were no significant differences in QI activities between the 2 groups except in activities associated with status of their practice as a patient-centered medical home. Conclusions Most but not all family medicine graduates reported they were actively involved in QI activities within their practices, independent of their exposure to a QI curriculum during training.

Patient care conference: a coordinated, collaborative effort

1996 ◽  
Vol 16 (5) ◽  
pp. 77-83 ◽  
Author(s):  
AM Kallenbach ◽  
DS Meyer
Keyword(s):  
Quality Improvement ◽  
Patient Care ◽  
Continuous Quality Improvement ◽  
Task Force ◽  
Treatment Plan ◽  
Problem Definition ◽  
Healthcare Team ◽  
Collaborative Effort ◽  
Continuous Quality ◽  
Care Conference

The flow chart, guidelines, and document describe the mechanism for patient care conferences. Because the need, process, and documentation of patient care conferences have been clarified, care conferences are now more consistent, efficient, and effective. Documentation streamlined the process of setting up care conferences by recording the following information: who was notified, who would attend, specific issues to be discussed, conference scheduling summary of plans and decisions made. Task force satisfaction was high because of a short timeline, clear problem definition, clear goals, team sponsorship, and a good end product. Use of continuous quality improvement techniques added to the success of this project, because there was a methodology for starting with a variable, unclear process and ending with a creative, efficient process. All members of the healthcare team and patients and families were satisfied, because the patient care conference was available to discuss specific issues and reach consensus on decisions about the patient's treatment plan at critical points during the patient's hospital course.

scholarly journals Integration of Continuous Quality Improvement Methods Into Annual Program and Institutional Evaluation

2019 ◽  
Vol 11 (5) ◽  
pp. 585-591
Author(s):  
R. Brent Stansfield ◽  
Tsveti Markova ◽  
Richard Baker
Keyword(s):  
Program Evaluation ◽  
Quality Improvement ◽  
Continuous Quality Improvement ◽  
Evaluation Process ◽  
Program Improvement ◽  
Action Item ◽  
Graduate Medical ◽  
Institutional Goals ◽  
Continuous Quality ◽  
Time Required

ABSTRACT Background The Accreditation Council for Graduate Medical Education's Next Accreditation System requires continuous program improvement as part of program evaluation for residency training institutions and programs. Objective To improve the institutional- and program-level evaluation processes, to operationalize a culture of continuous quality improvement (CQI), and to increase the quality and achievement of action items, the Wayne State University Office of Graduate Medical Education (WSU GME) incorporated CQI elements into its program evaluation process. Methods Across 4 academic years, WSU GME phased the following 4 CQI elements into the evaluation process at the program and institutional levels, including the annual program evaluation (APE) and the annual institutional review: (1) An APE template; (2) SMART (specific, measurable, accountable, realistic, timely) format for program and institutional goals; (3) Dashboard program and institutional metrics; and (4) Plan-do-study-act cycles for each action item. Results Action item goals improved in adherence to the SMART format. In 2014, 38% (18 of 48) omitted at least 1 field, compared with 0% omitting any fields in 2018. More complete action items took less time to resolve: 1.7 years compared with 2.4 years (t(43.3) = 2.87, P = .003). The implementation of CQI in the APE was well received by program leadership. Conclusions After leveraging CQI methods, both descriptions of institutional- and program-level goals and the time required for their achievement improved, with overall program director and program coordinator satisfaction.

scholarly journals Continuous Quality Improvement Measured With Time-Driven Activity-Based Costing in an Outpatient Cancer Surgery Center

2019 ◽  
Vol 15 (2) ◽  
pp. e162-e168
Author(s):  
Katy E. French ◽  
Iris Recinos ◽  
Alexis B. Guzman ◽  
Thomas A. Aloia ◽  
Mike Hernandez ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Patient Care ◽  
Continuous Quality Improvement ◽  
Care Delivery ◽  
Information Management System ◽  
Cancer Surgery ◽  
Care Process ◽  
Activity Based Costing ◽  
Continuous Quality ◽  
Surgery Center

PURPOSE: As health care costs rise, continuous quality improvement and increased efficiency are crucial to reduce costs while providing high-quality care. Time-driven activity-based costing (TDABC) can help identify inefficiencies in processes of cancer care delivery. This study measured the process performance of Port-a-Cath placement in an outpatient cancer surgery center by using TDABC to evaluate patient care process. METHODS: Data were collected from the Anesthesia Information Management System database and OneConnect electronic health record (EHR) for Port-a-Cath cases performed throughout four phases: preintervention (phase I), postintervention, stabilization, and pre–new EHR (phases II and III), and post–new EHR (phase IV). TDABC methods were used to map and calculate process times and costs. RESULTS: Comparing all phases, as measured with TDABC methodology, a decrease in post-anesthesia care unit (PACU) length of stay (LOS) was identified (83 minutes v 67 minutes; P < .05). The decrease in PACU LOS correlated with increased efficiency and decreasing process costs and PACU nurse resource use by fast tracking patients for Port-a-Cath placement. Port-a-Cath placement success and the functionality of ports remained the same as patient experience improved. CONCLUSION: TDABC can be used to evaluate processes of care delivery to patients with cancer and to quantify changes made to those processes. Patients’ PACU LOS decreased on the basis of the 2013 Port-a-Cath process improvement initiative and after implementation of a new EHR, over the course of 3 years, as quantified by TDABC. TDABC use can lead to improved efficiencies in patient care delivery that are quantifiable and measurable.

scholarly journals Superior Mesenteric Artery-Related Aortic Pseudomass as a Form of Reverberation Artifact in a 10-Year-Old Boy

2014 ◽  
Vol 4 ◽  
pp. 73
Author(s):  
Natalia Kokhanovsky ◽  
Alicia Nachtigal ◽  
Nadir Reindorp ◽  
Abdel-Rauf Zeina
Keyword(s):  
Computed Tomography ◽  
Quality Improvement ◽  
Image Quality ◽  
Patient Care ◽  
Superior Mesenteric Artery ◽  
Computed Tomography Angiography ◽  
Mesenteric Artery ◽  
Optimal Patient Care ◽  
Image Quality Improvement

Artifacts are encountered routinely in clinical ultrasonography practice. The ability to recognize and eliminate potentially correctable ultrasound artifacts is of great importance to image quality improvement and optimal patient care. We describe an example of a superior mesenteric artery-related pseudomass as a form of reverberation artifact that could lead to misinterpretation of sonographic findings. We present the ultrasonographic and computed tomography angiography findings and give an explanation for the appearance of the artifact.

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