Teaching Medical Faculty How to Apply Continuous Quality Improvement to Medical Education

Coleman, Mathew; Headrick, Linda A.; Langley, Albert E.; Thomas, Jane deLima

doi:10.1016/s1070-3241(16)30412-6

Cited by 14 publications

(11 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Its place in the curriculum of medical schools needs examination, and because of its pertinence to the work of tomorrow's doctors it needs to be included in core curriculums 11. This will have knock on effects for the roles and skills of academic staff12 as well as career paths. It may be best served by the establishment of new academic departments of healthcare improvement in medical schools10 to build students' understanding and practical improvement skills through the processes and the content of their learning.…”

mentioning

confidence: 99%

Putting improvement at the heart of health care

Wilcock¹,

Lewis²

2002

BMJ

View full text Add to dashboard Cite

mentioning

confidence: 99%

Putting improvement at the heart of health care

Wilcock¹,

Lewis²

2002

BMJ

View full text Add to dashboard Cite

“…Discussions about the application of quality improvement to health professions education have occurred since the early days of quality improvement in healthcare,8 – 12 but there are few examples in the literature. Hollander et al 13 described how a quality improvement approach improved a medical school curriculum reform, including an evaluation point before the new curriculum was launched 13.…”

Section: Discussionmentioning

confidence: 99%

How an educational improvement project improved the summative evaluation of medical students

Hoffman

Brown²,

Headrick³

2009

Quality and Safety in Health Care

View full text Add to dashboard Cite

This educational improvement project decreased waste, increased collaboration and developed locally useful knowledge. By applying continuous improvement principles to the construction of the MSPE the overall efficiency of the process could be enhanced, and the MSPE committee was able to spend less cognitive energy on structure and format and focus more on the content of the letters. Four MSPE cycles have been completed using a new Web-based system; after each cycle, additional enhancements were identified and implemented. This work adds to the literature, as it describes the application of continuous improvement principles to an educational system.

show abstract

“…For example, the 1000 Lives + programme team, improvement guides and local and national learning events each facilitate cognitive participation through education and practice-based skill development. Such learning, whether at an individual, 187,421,[425][426][427] an organisational 12,411 or a system-wide level, 24,428 is fundamental to health-care practice change, as is the need for senior organisational leaders to develop a comparable level of awareness of 1000 Lives + , the MI-PDSA approach and associated drivers. 429 Cognitive participation thus helps to ensure that systemic and organisational factors giving rise to patient neglect are addressed, 430 while knowledge sharing and trust are enhanced.…”

Section: Cognitive Participationmentioning

confidence: 99%

A realist analysis of hospital patient safety in Wales: applied learning for alternative contexts from a multisite case study

Herepath

Kitchener

Waring

2015

Health Serv Deliv Res

View full text Add to dashboard Cite

BackgroundHospital patient safety is a major social problem. In the UK, policy responses focus on the introduction of improvement programmes that seek to implement evidence-based clinical practices using the Model for Improvement, Plan-Do-Study-Act cycle. Empirical evidence that the outcomes of such programmes vary across hospitals demonstrates that the context of their implementation matters. However, the relationships between features of context and the implementation of safety programmes are both undertheorised and poorly understood in empirical terms.ObjectivesThis study is designed to address gaps in conceptual, methodological and empirical knowledge about the influence of context on the local implementation of patient safety programmes.DesignWe used concepts from critical realism and institutional analysis to conduct a qualitative comparative-intensive case study involving 21 hospitals across all seven Welsh health boards. We focused on the local implementation of three focal interventions from the 1000 Lives+patient safety programme: Improving Leadership for Quality Improvement, Reducing Surgical Complications and Reducing Health-care Associated Infection. Our main sources of data were 160 semistructured interviews, observation and 1700 health policy and organisational documents. These data were analysed using the realist approaches of abstraction, abduction and retroduction.SettingWelsh Government and NHS Wales.ParticipantsInterviews were conducted with 160 participants including government policy leads, health managers and professionals, partner agencies with strategic oversight of patient safety, advocacy groups and academics with expertise in patient safety.Main outcome measuresIdentification of the contextual factors pertinent to the local implementation of the 1000 Lives+patient safety programme in Welsh NHS hospitals.ResultsAn innovative conceptual framework harnessing realist social theory and institutional theory was produced to address challenges identified within previous applications of realist inquiry in patient safety research. This involved the development and use of an explanatory intervention–context–mechanism–agency–outcome (I-CMAO) configuration to illustrate the processes behind implementation of a change programme. Our findings, illustrated by multiple nested I-CMAO configurations, show how local implementation of patient safety interventions are impacted and modified by particular aspects of context: specifically, isomorphism, by which an intervention becomes adapted to the environment in which it is implemented; institutional logics, the beliefs and values underpinning the intervention and its source, and their perceived legitimacy among different groups of health-care professionals; and the relational structure and power dynamics of the functional group, that is, those tasked with implementing the initiative. This dynamic interplay shapes and guides actions leading to the normalisation or the rejection of the patient safety programme.ConclusionsHeightened awareness of the influence of context on the local implementation of patient safety programmes is required to inform the design of such interventions and to ensure their effective implementation and operationalisation in the day-to-day practice of health-care teams. Future work is required to elaborate our conceptual model and findings in similar settings where different interventions are introduced, and in different settings where similar innovations are implemented.FundingThe National Institute for Health Research Health Services and Delivery Research programme.

show abstract

Teaching Medical Faculty How to Apply Continuous Quality Improvement to Medical Education

Cited by 14 publications

References 5 publications

Putting improvement at the heart of health care

Putting improvement at the heart of health care

How an educational improvement project improved the summative evaluation of medical students

A realist analysis of hospital patient safety in Wales: applied learning for alternative contexts from a multisite case study

Contact Info

Product

Resources

About