Introduction: Medical students are the future drivers of change in health care. The AAMC encourages quality improvement and patient safety (QI/PS) education. Unfortunately, many schools do not have a formal QI/PS curriculum. To offer the patient-centered, safe, evidence-based, and high-value care patients deserve, students will be expected to have both knowledge of and experience in QI/PS. This extracurricular experiential QI/PS curriculum is designed to prepare medical students for this role. Methods: The curriculum includes six monthly didactic and work-group sessions that cover QI/PS fundamentals and facilitate the design and implementation of student projects. Results: Twenty-two medical students, with representation from academic years 1-4, completed the curriculum. The average Quality Improvement Knowledge Application Tool-Revised score increased from 5.61 to 7.75 (p < .01). Six projects were undertaken, with teams completing an average of 2.83 plan-do-study-act cycles. Projects decreased Clostridium difficile ordering, reduced discordance between documented and true intraoperative wound classification, and increased the quantity and quality of patient sleep. Responding "Agree" or "Strongly Agree," 80.9% of students felt their practice would change due to this experience, and 96.5% planned on participating in QI/PS in the future. Four students volunteered to continue as student leaders. Many students (96.5%) felt their experience was good or very good. Discussion: This ready-to-implement curriculum offers medical students an opportunity to obtain the knowledge and experience necessary to participate meaningfully in QI/PS now and throughout their careers.
Background: Hospitalizations related to the consequences of opioid use are rising.National guidelines directing in-hospital opioid use disorder (OUD) management do not exist. OUD treatment guidelines intended for other treatment settings could inform in-hospital OUD management.Objective: Evaluate the quality and content of existing guidelines for OUD treatment and management.
Background People with opioid use disorder experience high burden of disease from medical comorbidities and are increasingly hospitalized with medical complications. Medications for opioid use disorder are an effective, life-saving treatment, but patients with an opioid use disorder admitted to the hospital seldom initiate medication for their disorder while in the hospital, nor are they linked with outpatient treatment after discharge. The inpatient stay, when patients may be more receptive to improving their health and reducing substance use, offers an opportunity to discuss opioid use disorder and facilitate medication initiation and linkage to treatment after discharge. An addiction-focus consultative team that uses evidence-based tools and resources could address barriers, such as the need for the primary medical team to focus on the primary health problem and lack of time and expertise, that prevent primary medical teams from addressing substance use. Methods This study is a pragmatic randomized controlled trial that will evaluate whether a consultative team, called the Substance Use Treatment and Recovery Team (START), increases initiation of any US Food and Drug Administration approved medication for opioid use disorder (buprenorphine, methadone, naltrexone) during the hospital stay and increases linkage to treatment after discharge compared to patients receiving usual care. The study is being conducted at three geographically distinct academic hospitals. Patients are randomly assigned within each hospital to receive the START intervention or usual care. Primary study outcomes are initiation of medication for opioid use disorder in the hospital and linkage to medication or other opioid use disorder treatment after discharge. Outcomes are assessed through participant interviews at baseline and 1 month after discharge and data from hospital and outpatient medical records. Discussion The START intervention offers a compelling model to improve care for hospitalized patients with opioid use disorder. The study could also advance translational science by identifying an effective and generalizable approach to treating not only opioid use disorder, but also other substance use disorders and behavioral health conditions. Trial registration: Clinicaltrials.gov: NCT05086796, Registered on 10/21/2021. https://www.clinicaltrials.gov/ct2/results?recrs=ab&cond=&term=NCT05086796&cntry=&state=&city=&dist =
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.