Quality Improvement/Patient Safety The IHI Student Consortium

1. Quality Improvement/Patient SafetyThe IHI Student Consortium

2. The Quality ProjectPresented by the IHI Student ConsortiumThe Quality Project is a collaboration among preclinical and clinical students, residents, fellows, faculty, and administrators across Stanford. Our mission is to develop higher quality healthcare that is more safe, effective, patient-centered, timely, efficient, and equitable through education, research, advocacy, and implementation.

3. IHI Student Consortium Education Research Advocacy Implementation

4. Education Research Advocacy Implementation • Leadership Course • QI Lecture Series • QI Clinical Elective • QI in Q6 • Med-Scholars • Internal Medicine Program • Hand Hygiene Project • Leadership Training in Medicine • Global Safe Surgery Mentor Project • Patient-Centered Care in Fellowship • CBEI & Quality • Team Easy • Hospital Management Collaborative • Hand Hygiene: Implementation • Pacific Free Clinic Quality Initiative

5. Medical Leadership Development Matthew Goldstein, SMS VI Robin Eisenhut, SMS III Barnard Palmer, MD Tiffany Castillo, SMS V

6. Leadership Training in Medicine • Initiated in 2008 • PEDS 201: 1 unit, Fall Quarter • Course Director: Charles Prober • Facilitator: Julia Tussing • Students: • Received 40 applications for 8 medical student spots • 8 Medical Students (Years 1-3) • 4 Chief Residents (Medicine, Surgery, Pediatrics, Psychiatry) • Topics: • What is Leadership? • Self-Knowledge • Communication & Emotional Intelligence • Conflict Management • Influence • Effective Teams

9. Future Iterations… • The Reality: • insert or piggy-back on select components in existing curricula if all students are to be exposed • continue to offer an elective or encourage students to utilize GSB/VPGE leadership courses • The Ideal: • full-year, independent course • integrated into curriculum • more of a t-group model • inter-disciplinary effort between GSB and SoM • mandatory for all students

10. Internal Medicine QI Elective & A Hand Hygiene Project Kambria Hooper, M.Ed. Stephanie Carr, SMS III

11. Internal Medicine QI Elective • Initiated in 2010 • MED 344A: 6 unit, Any Quarter • Course Director: Clarence Braddock • Topics: • Mentored practice and growth in knowledge, skills, and attitudes in quality improvement, patient safety, and organizational change • Directed readings, attend sessions with experienced QI champions • Learn about quality improvement projects and processes at Stanford University • Participate in ongoing quality and patient safety activities within the Department of Medicine and Stanford Hospital and Clinics • Design and begin a quality improvement/patient safety/organizational change project • Develop a mentoring relationship with a QI champion who will serve as a role model, mentor, and educator

12. Stephanie Carr: Hand Hygiene – Follow the Leader? • Hypothesis: • To determine whether the hand hygiene habits of attending physicians or the first person entering/exiting the patient room influenced the compliance of other physician team members. • Method: • Four medical students individually shadowed physician teams during morning rounds and measured hand hygiene compliance • Results: • Physician team members were more likely to wash their hands upon entering and exiting patient rooms if their attendings washed (75% v. 29%; p < 0.001) • Team members were also more likely to wash if the first person entering/exiting washed (75% v. 31%; p < 0.001) • Conclusion: • Efforts to improve hand hygiene compliance should be directed towards the attendings.

13. Team Easy:Incorporating Quality Improvement (QI) into Stanford Medical Curricula Shubha Bhat, SMS II Natalia Leva, SMS II Felipe Perez, SMS II Julia Pederson, SMS II Stephanie Smith, SMS II

14. Team EASY: advocacy project • Goal: Incorporate QI training into longitudinal medical curriculum • Process: Needs assessment with stakeholders • Outcomes: • “QI in Q6" pilot project, June 2010 • Recommendations for QI Core Competencies • CCAP working group formed • Next steps: • Build support and interest among students and faculty • Develop, pilot, and implement QI curriculum

15. Team Easy Advocacy Project

16. Team Easy: Stanford QI Training Environment

18. The Hospital Management CollaborativePromoting Patient Safety Entrepreneurship Nirav Kamdar, MD MPP Department of Internal Medicine

19. Education SOM Centers CERC HMC Class Clinical Effectiveness IHI Breakthrough Projects Quality Working Groups QI Resident Elective Quality Council QI Team Challenge QIPSC

20. HMC: Goals • Create a health system modeling pipeline • Provide access to primary data • Provide exposure to real health management problems • Provide a client experience with support • Increase academic leadership in quality improvement • Increase resident publication opportunities

21. HMC: What we need… • Single roundtable meeting with multidisciplinary faculty • Direct interaction with CERC’s strategic plan • Organizational personnel to develop HMC course and coordinate project teams

22. Conclusions

23. Conclusions • Align student initiatives with faculty/administration projects already underway • Help facilitate a round table meeting with multidisciplinary faculty and students* • Provide students with opportunities for internships, rotations, and research in the QI/PS space • Incorporate quality improvement and patient safety as a core competency throughout undergraduate and graduate medical education