Resident and Fellow Engagement in Safety and Quality

Bowe, Sarah N.; McCormick, Michael E.

doi:10.1016/j.otc.2018.08.010

Cited by 7 publications

(4 citation statements)

References 22 publications

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“…To create change within the “team culture,” programs should embrace the idea of a “just culture,” in which trainees are not punished for expressing concerns and viewpoints 59 . Such a culture has recently been proposed in the field of patient safety and quality improvement (PS/QI) to improve safety 59 .…”

Section: Discussionmentioning

confidence: 99%

“…58 To create change within the ''team culture,'' programs should embrace the idea of a ''just culture,'' in which trainees are not punished for expressing concerns and viewpoints. 59 Such a culture has recently been proposed in the field of patient safety and quality improvement (PS/QI) to improve safety. 59 It has been noted that for an individual to feel comfortable enough to have a voice, several criteria, including safety (freedom from fear of retribution), opportunity (forum for making voice heard), and legitimacy (feeling as though one's voice actually matters), must be met.…”

Section: Strategies For Changementioning

confidence: 99%

“…59 Such a culture has recently been proposed in the field of patient safety and quality improvement (PS/QI) to improve safety. 59 It has been noted that for an individual to feel comfortable enough to have a voice, several criteria, including safety (freedom from fear of retribution), opportunity (forum for making voice heard), and legitimacy (feeling as though one's voice actually matters), must be met. 32 In systems where leaders display openness, use transformational behaviors, and encourage staff to use their voice, employees are naturally more inclined to bring forth concerns instead of staying quiet.…”

Section: Strategies For Changementioning

confidence: 99%

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Consequences of Medical Hierarchy on Medical Students, Residents, and Medical Education in Otolaryngology

Salehi

Jacobs

Suhail-Sindhu

et al. 2020

Otolaryngol.--head neck surg.

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Objective To (1) review concepts of medical hierarchy; (2) examine the role of medical hierarchy in medical education and resident training; (3) discuss potential negative impacts of dysfunctional hierarchy in medical and surgical training programs, focusing on otolaryngology; and (4) investigate solutions to these issues. Data Sources Ovid Medline, Embase, GoogleScholar, JSTOR, Google, and article reference lists. Review Methods A literature search was performed to identify articles relating to the objectives of the study using the aforementioned data sources, with subsequent exclusion of articles believed to be outside the scope of the current work. The search was limited to the past 5 years. Conclusions Two types of hierarchies exist: “functional” and “dysfunctional.” While functional medical hierarchies aim to optimize patient care through clinical instruction, dysfunctional hierarchies have been linked to negative impacts by creating learning environments that discourage the voicing of concerns, legitimize trainee mistreatment, and create moral distress through ethical dilemmas. Such an environment endangers patient safety, undermines physician empathy, hampers learning, lowers training satisfaction, and amplifies stress, fatigue, and burnout. On the other hand, functional hierarchies may improve resident education and well-being, as well as patient safety. Implications for Practice Otolaryngology–head and neck surgery programs ought to work toward creating healthy systems of hierarchy that emphasize collaboration and improvement of workplace climate for trainees and faculty. The goal should be to identify aspects of dysfunctional hierarchy in one’s own environment with the ambition of rebuilding a functional hierarchy where learning, personal health, and patient safety are optimized.

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Section: Discussionmentioning

confidence: 99%

Section: Strategies For Changementioning

confidence: 99%

Section: Strategies For Changementioning

confidence: 99%

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Consequences of Medical Hierarchy on Medical Students, Residents, and Medical Education in Otolaryngology

Salehi

Jacobs

Suhail-Sindhu

et al. 2020

Otolaryngol.--head neck surg.

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“…Responding residents noted a desire for formal curricula and resources to learn QIPS methodologies, a position that has previously been endorsed by other groups in medical education, including Canadian EM residency program directors. 13,14,17,18 Despite both residents and program leadership desiring formal QIPS curricula, our results demonstrate that QIPS is taught in at least a third of the programs. A recognized potential barrier to the successful implementation of QIPS curricula in both our results and the literature is the lack of local faculty QIPS expertise and experience.…”

Section: Experience With Qipsmentioning

confidence: 77%

Residents’ perspective of quality improvement and patient safety education in Canadian emergency medicine residency programs

Trivedi

Hartmann

Hall

et al. 2020

CJEM

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ObjectivesQuality improvement and patient safety (QIPS) competencies are increasingly important in emergency medicine (EM) and are now included in the CanMEDS framework. We conducted a survey aimed at determining the Canadian EM residents’ perspectives on the level of QIPS education and support available to them.MethodsAn electronic survey was distributed to all Canadian EM residents from the Royal College and Family Medicine training streams. The survey consisted of multiple-choice, Likert, and free-text entry questions aimed at understanding familiarity with QIPS, local opportunities for QIPS projects and mentorship, and the desire for further QIPS education and involvement.ResultsOf 535 EM residents, 189 (35.3%) completed the survey, representing all 17 medical schools; 77.2% of respondents were from the Royal College stream; 17.5% of respondents reported that QIPS methodologies were formally taught in their residency program; 54.7% of respondents reported being “somewhat” or “very” familiar with QIPS; 47.2% and 51.5% of respondents reported either “not knowing” or “not having readily available” opportunities for QIPS projects and QIPS mentorship, respectively; 66.9% of respondents indicated a desire for increased QIPS teaching; and 70.4% were interested in becoming involved with QIPS training and initiatives.ConclusionsMany Canadian EM residents perceive a lack of QIPS educational opportunities and support in their local setting. They are interested in receiving more QIPS education, as well as project and mentorship opportunities. Supporting residents with a robust QIPS educational and mentorship framework may build a cohort of providers who can enhance the local delivery of care.

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Grassroots Culture: Patient Safety Approach to a Quality Curriculum for House Staff

Guthrie

McIntyre²,

Gala³

2022

Optimizing Widely Reported Hospital Quality and Safety Grades

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Resident and Fellow Engagement in Safety and Quality

Cited by 7 publications

References 22 publications

Consequences of Medical Hierarchy on Medical Students, Residents, and Medical Education in Otolaryngology

Consequences of Medical Hierarchy on Medical Students, Residents, and Medical Education in Otolaryngology

Residents’ perspective of quality improvement and patient safety education in Canadian emergency medicine residency programs

Grassroots Culture: Patient Safety Approach to a Quality Curriculum for House Staff

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