Faculty Chair:

Dolores Gomez, MD

Contacts:

1. Dolores Gomez, MD

2. John Andazola, MD

3. Mary Alice Scott, PhD

4. Sarah Summers-Barrio, DNP

5. Patrick Leung, PharmD

Required Experiences:

1. Memorial Medical Center

2. Southern New Mexico Family Medicine Clinic

Weekly Schedule:

This curriculum is a longitudinal curriculum that will be applied during the three years of residency. Therefore, information and presentations will be done during the resident’s time at the residency program. This will include completion of the Institute for Healthcare Improvement by the end of the residency.

Requirements:

AOA

Patient Safety and Quality Improvement

The program must provide training in patient safety and quality improvement. At a minimum this shall include:

Identification and analysis of inpatient and ambulatory measures of quality.
Utilization of quality measurements to improve patient care.
Participation in at least one national or regional quality improvement registry.
Training in the principles of the Patient Centered Medical Home (PCMH).

ACGME

The program director must ensure that residents are integrated and actively participate in interdisciplinary clinical quality improvement and patient safety programs. (Core)

Description of Rotation or Educational Experience

Quality Improvement (QI) is a method of continuously examining processes and making them more effective. It’s an idea that started in the business community as companies looked for better ways to produce better products and services for their customers. Over the last deca de, the idea has spread into the medical community as more and more physicians have turned to QI theories to improve both the clinical and operational aspects of their practices . Its principles have helped family physicians increase the use of preventative services, improve coding accuracy, improve phone access and decrease patients’ waiting times, among other successes.

The principles of QI include these:

• A strong focus on patients

• Continuous improvement of all processes

• Involvement of the entire organization in the pursuit of quality

• Use of data and team knowledge to improve decision making

Patient Care

Goal

Residents must be able to provide patient care that is compassionate, appropriate, and effective for the treatment of health problems and the promotion of health. Residents are expected to:

Competencies

• Understand the importance of quality improvement as it relates to the care and treatment of patients

• Develop a process within the clinic and hospital setting to find underlying patient care issues that may need improvement

• Understand that quality improvement as it relates to patient care is a continuous process

Objectives

• Create questions within the family medicine clinic that address problems with patient care as it relates to quality improvement

• List various medical issues that relate to patient care that can be addressed in a quality improvement study

• Use electronic medical records in the clinic setting to determine areas in patient care that could undergo quality improvement

Medical Knowledge

Goal

Residents must demonstrate knowledge of established and evolving biomedical, clinical, epidemiological, and social-behavioral sciences, as well as the application of this knowledge to patient care. Residents are expected to:

Competencies

• Understand the principles of quality improvement and how it relates to patient care and improvement of individuals and systems practice of medicine

• Develop quality improvement studies within the clinic and hospital settings using the PDSA and FOCUS models of quality improvement

Objectives

• List the parts of a FOCUS model

• List the PDSA cycle

• List the 8 steps to a chart audit for quality

• Present a topic of quality improvement and develop questionnaire as it relates to the improvement of that topic

Practice- Based Learning and Improvement

Goal

Residents must demonstrate the ability to investigate and evaluate their care of patients, to appraise and assimilate scientific evidence, and to continuously improve patient care based on constant self-evaluation and life long learning. Residents are expected to develop skills and habits to be able to:

Competencies

• Identify strengths, deficiencies and limits in one’s knowledge and expertise as well as the clinic’s limitations as it relates to quality improvement

• Set learning and improvement goals for related topics

• Identify and perform appropriate learning activities

• Systematically analyze practice, using quality improvement methods, and implement changes with the goal of practice improvement

• Incorporate formative evaluation feedback into daily practice

• Locate, appraise and assimilate evidence from scientific studies related to their patients’ health problems

• Use information technology to optimize learning

• Participate in the education of patients, families, students, residents and other health professionals, as documented by evaluations of a resident’s teaching abilities by faculty and/or learners

Objectives

• Identify a clinic process to improve within the clinic and/or hospital setting

• Perform a quality improvement study with entire clinic to improve patient care and clinic processes

• Analyze data collected and use to improve care of the patient and the clinic or hospital processes as related to the QI project

Systems Based Practice

Goal

Residents must demonstrate an awareness of and responsiveness to the larger context and system of health care, as well as the ability to call effectively on other resources in the system to provide optimal health care. Residents are expected to:

Competencies

• Coordinate patient care within the health care system relevant to their clinical specialty

• Incorporate considerations of cost awareness and risk-benefit analysis in patient care

• Advocate for quality patient care and optimal patient care systems

• Work in interprofessional teams to enhance patient safety and improve patient care quality

• Participate in identifying systems errors and in implementing potential systems solutions

Objectives

• Develop a list of quality improvement issues with clinic staff, nurses, and physicians to address in a QI project

• List barriers within the clinic and hospital system that could benefit from quality improvement

Professionalism

Goal

Residents must demonstrate a commitment to carrying out professional responsibilities and an adherence to ethical principles. Residents are expected to demonstrate:

Competencies

• Compassion, integrity, and respect for others

• Responsiveness to patient needs that supersedes self-interest

• Accountability to patients, society, and the profession

Objectives

• Complete quality improvement projects in a timely manner

• Model professional behavior with peers, clinical staff, nurses, and administrators

• Accurately and honestly report QI findings

Interpersonal and Communication Skills

Goal

Residents must demonstrate interpersonal and communication skills that result in the effective exchange of information and teaming with patients, their families, and professional associates. Residents are expected to:

Competencies

• Communicate effectively with patients and families across a broad range of socioeconomic and cultural backgrounds

• Communicate effectively with physicians, other health professionals, and health related agencies

• Work effectively as a member of leader of a health care team or other professional group

Objectives

• Be a QI champion and actively support your teams

• Cultivate a spirit of QI within the residency practice that encourages everyone to improve the quality of services and programs continuously

• Develop a set of improvement principles to help guide the quality improvement of the residency practice

Teaching Methods

Quality improvement didactics on a 3-6month basis will be conducted during didactics. Residents are responsible for reading articles in the QI curriculum

Assessment Method (residents)

Residents with conduct, review, and reconduct QI projects throughout their 3 year residency and assess their improvement as well as the clinic and hospital improvement in these projects