Instruments with reasonable validity are available for evaluating some domains of EBP and may be targeted to different evaluation needs. Further development and testing is required to evaluate EBP attitudes, behaviors, and more recently articulated EBP skills.
The provision of high-quality, efficient care results from the coordinated, cooperative efforts of multiple technically competent health care providers working in concert over time, spanning disciplinary and professional boundaries. Accordingly, the role of medical education must include the development of providers who are both expert clinicians and expert team members. However, the competencies underlying effective teamwork are only just beginning to be integrated into medical school curricula and residency programs. Therefore, continuing education (CE) is a vital mechanism for practitioners already in the field to develop the attitudes, behaviors (skills), and cognitive knowledge necessary for highly reliable and effective team performance.The present article provides an overview of more than 30 years of evidence regarding team performance and team training in order to guide, shape, and build CE activities that focus on developing team competencies. Recognizing that even the most comprehensive and well-designed team-oriented CE programs will fail unless they are supported by an organizational and professional culture that values collaborative behavior, ten evidence-based lessons for practice are offered in order to facilitate the use of the science of team-training in efforts to foster continuous quality improvement and enhance patient safety.
Building the Bridge to Quality: Speaker: Brian M. Wong, Building the Bridge to Quality Meeting Chair Opening plenary that highlights the urgent need to bridge the quality and safety gap by aligning education and clinical care around a single common goal: high quality safe patient care
The US health care system relies on highly resourced tertiary and quaternary hospitals receiving patients from hospitals that are unable to provide these levels of specialty care. These latter hospitals, often in sparsely populated rural areas or underresourced urban areas, are typically not equipped to provide the consultative, procedural, and surgical expertise found in larger systems.Substantial effort and expenditure have gone into developing complex systems for transferring patients with time-sensitive conditions, such as trauma, myocardial infarction, and stroke, largely relying on regional centers located in more populated areas.The recent surge in cases of COVID-19 has reinforced how rapidly hospitals within a broad geographic region can be overwhelmed. Widespread staffing shortages are exacerbating these conditions and substantially constraining health care surge capacity. These problems have been increasingly highlighted in the media as contributors to COVID-19 and non-COVID-19 mortality. 1 Hospital load-balancing initiatives have been developed in some states to ensure access to necessary inpatient care during the COVID-19 pandemic. As leaders in 3 of these statewide initiatives in Washington, Minnesota, and Arizona, our centers have facilitated the coordination and transfer of more than 15 000 patients from April 2020 through November 2021. In this Viewpoint, we present lessons learned from these centralized, regional, load-balancing services. To promote equitable and
Medical education in the United States of America (USA), and worldwide, is increasingly concentrating on the process and outcome of the educational experience. The first efforts to substantially improve medical education in the USA resulted in the Flexner Report in the early 1900s. The release of this report led to significant advancements in the quality of curriculum content. However, in the past few decades there has been increasing realization that delivery of content will not, by itself, assure the development of excellent physicians. As a result, there has been an increasing emphasis on the process, and, most recently, the outcome, of medical education. Process movements have examined the context and methods for teaching and learning. The problem-based learning movement is perhaps the most widely-known example of process trends. The latest trends in USA medical education focus on the outcomes of the learning process. At the forefront of this movement is the American Council on Graduate Medical Education (ACGME), which accredits all USA post-graduate training programs. Recently, the ACGME has defined a set of six core clinical competencies that all graduates must demonstrate. A second emerging trend is inter-professional education. Increasingly, healthcare is provided by inter-professional healthcare team, and students must be competent to function effectively in this setting. Many academic health centers are developing joint curricula to address this need. Medical education has evolved from a primary focus on content to an emphasis on process of teaching and learning, and will increasingly concentrate on educational outcomes.
THE HEALTH CARE TEAM CHALLENGE TM : DEVELOPING AN INTERNATIONAL INTERPROFESSIONAL EDUCATION RESEARCH COLLABORATIONInterprofessional education (IPE) to improve and increase interprofessional collaborative practice (IPC) has been documented for over 50 years in Canada, but it is within the last 15 years that it has gained attention in research, education and practice contexts. IPE is defined as two or more professions that learn with from and about each other to improve collaboration and the quality of care (Caipe 2002). Early drivers for a renewed interest in IPE and IPC derive from an emerging interest in new health service delivery models such as integrated care clinics and primary health care and IPE and IPC have taken centre stage nationally and globally. Research evidence is emerging (Baker, 2010) which demonstrates the value of IPC in areas such as harm reduction, reduced length of stay, sustainable health outcomes, and staff recruitment and retention. Most education programs are starting to embed IPE in their entry-level curricula and increasing attention to continuing professional develop is emerging.The barriers and curricular challenges remain. Entry-level curricula are crammed and lack the flexibility and nimbleness required to identify common learning times; student clinical placements across the professions are not aligned and make it difficult to locate interprofessional groups of students in any given practice setting; faculty and preceptor development for interprofessional teaching is rarely highlighted; student value of IPE is weakened when IPE is not mainstreamed in curricula; human, financial and space resources are stretched and IPE often falls to the lower priority levels. A C C E P T E D M A N U S C R I P T ACCEPTED MANUSCRIPT 3Other documented barriers include professional regulatory requirements, non-existent institutional policies that allow sharing of course credits across programs or universities, lack of senior management/ administrative commitment, poor understanding of other professions and separate professional languages (Moran et al, 2007).In reality we have a conundrum. In response to the emerging evidence that collaborative practice among health care providers does improve quality of care and patient outcomes, IPE is viewed as an essential educational process aimed at developing interprofessional collaborative practice capabilities (Barr and Ross, 2006;Baker, 2010). Government agencies, academic accrediting councils, health professions organizations and the literature stress the need for IPE (Baker, 2010), yet evidencedbased suggestions as to how this should be accomplished are only slowly emerging.Innovative interprofessional learning opportunities are needed to ensure that students actively participate (Moran et al, 2007). Yet currently the literature lacks strategies that foster collaborative learning among professions that are versatile and easy to implement locally and internationally. implementing IPE programs will occur that encourages students to engage in collaborative p...
Background Integrating teaching and hands-on experience in quality improvement (QI) may increase the learning and the impact of resident QI work.
Integrating QI teaching into the routine clinical and educational systems of an inpatient service is challenging. Identifiable, concrete strategies in the setting, learner, and teacher domains helped integrate QI into the clinical and educational systems.
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