Engaging Students in a Quality
Improvement Movement Friday, Mar 3, 2017
Breakout Session G8
James Chan & Sarah Fraser – Presenters
Dr. Cheryl Holmes, Brandon Evtushevski, Jung-In Choi
Disclosure
We have nothing to disclose.
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What’s the Problem?
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• Generally, there is low physician involvement in QI1,2
• Why are physicians reluctant to participate in the quality improvement process?
• Why is physician engagement important?
– Physician engagement is key to delivering safe, high-quality health care3
2/27/2017 4 © 2007 Institute of Health Improvement
IHI White Paper on Physician Engagement4
Comparison: IAP2 Spectrum of Engagement5
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How can we engage physicians in quality
and safety?
• Physicians are trained on technical skills and
clinical conditions6
• Trouble generating enthusiasm from physicians,
who are challenged by the demands of
their daily professional and business lives
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Go Upstream – Engage Trainees
• Established an IHI Open School Chapter at UBC-Okanagan
• Created partnership with faculty leaders and Interior Health
• Engage future and current healthcare professionals
– Encourage activities with mentors, mutual learning, and sustained improvement
• Goal: Foster an early “acceptance” of QI/early exposure to QI
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IHI Open School UBCO
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December 2015 New MD Curricular activity: IHI Basic Certificate
April 2016 24 Medical students completed Basic Certificate
September 2016 UBC-Okanagan establishes IHI Open School
October 2016 UBCO Open School Connects with Interior Health
January 2017 UBCO Open School Students participate in QI projects
Outcomes
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Outcomes
• Students are participating in ongoing projects
– Lean Rapid Process Improvement Workshop
– 48/6
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Example: RPIW
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Outcomes
• 1/3 of the Southern Medical Program 2019 class has completed the basic certificate
• “It taught me effective ways to speak up if I don’t feel comfortable or if I think something is dangerous”
• “I felt empowered from the videos and stories of other medical students, which made the material relevant to me right now”
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Student Comments
• “I realize now that quality improvement is not
only an option at this point in my training,
rather it is an obligation”
• “ This course has permanently altered my
ability to perceive areas involving QI and has
increased my willingness to engage those
issues”
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What am I still struggling with/need help with?
• Sustainability
• Developing the interdisciplinary aspect
– Expansion to other departments (e.g. nursing,
dentistry)
• Involving students in ongoing projects
– Timing and availability
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Group Discussion
• What types are roles do physicians play in
quality and safety?
• Is there a role for students in quality and
safety?
• Have you seen successful student engagement?
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Contact Information
James Chan, MA, PhD (c) Corporate Director – Quality, Risk and Accreditation
Sarah Fraser, BSc, MD (c) University of British Columbia, Southern Medical Program
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References 1. Cohen, A.B., Restuccia, J.D., Shwartz, M., Drake, J.E., Kang, R., Kralovec, P., Holmes,
S.K., Margolin, F. & Bohr, D. (2008). A survey of hospital quality improvement activities. Medical Care Research and Review, 65(5), 571-595.
2. Zoutman, D.E., & Ford, B.E. (2017). Quality Improvement in hospitals: Barriers and facilitators. International Journal of Healthcare Quality Assurance, 30(1), 16-24.
3. The King’s Fund (2012). Leadership and engagement for improvement in the NHS: Together we can. Retrieved from https://www.kingsfund.org.uk/sites/files/kf/field/field_publication_file/leadership-for-engagement-improvement-nhs-final-review2012.pdf
4. Reinertsen, J.L., Gosfield, A.G., Rupp, W., Whittington, J.W. (2007). Engaging Physicians in a Shared Quality Agenda. IHI Innovation Series white paper. Cambridge, Massachusetts: Institute for Healthcare Improvement. Author.
5. International Association for Public Participation - IPA2 (2017). Spectrum of Engagement. Retrieved from http://www.iap2.org/search/all.asp?bst=spectrum+of+engagement
6. Caldwell, C., Brexler, J., & Gillem, T. (2005). Engaging physicians in Lean six sigma. Quality Progress, 38(4),11-16.
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