As health professions educators, we strive to train professionals who deliver high quality care that is timely, effective, efficient, equitable, patient-centered, and safe. Health professions education is necessary but not sufficient for high quality care and requires more than principles of quality improvement - involving all stakeholders to make the changes that will lead to better patient outcomes, better system and better professional development are fundamental to change and are often more readily accessible than it may seem.
The October #HMIChat “The Synergy of Quality Improvement and Education in Healthcare” resulted in robust discussion by the community of practice on the “why” and “how” participants contextualize education in healthcare quality improvement.
We noted that discussion tended to fall in 3 key areas:
- The definition of “healthcare quality” is personal:
Participants’ definition of healthcare quality included the concept of balance in the techniques we use, the expectations we have of outcomes, and identification of stakeholder roles in the process. Overall everyone agreed that improvement in patient care is the nucleus of quality improvement. Here are two fantastic examples:
“It’s about putting the patient in the center and focusing on his/her need.”
“Quality is not just about ‘satisfaction,’ it really is about outcomes, soft and hard, that encompass both patient and provider and system perspectives”
When we prioritize patient care and engage them in quality improvement efforts, we send the message that our patients are the drivers of the education, training, and execution of initiatives in quality improvement.
- Humans are the most important component of change:
The chat emphasized the importance of all stakeholders being involved with the goal of improved patient safety. Learners are the drivers of the innovation we wish to see. We need to take into account their feedback during the processes but also their perspectives during debriefing. We can also show learners how to harness their energy for change using quality improvement tools to adjunct their learning and perspective QI methods. There were several examples provided on how educators incorporated student and patient voices into their clinical training efforts.
- Quality improvement principles, including psychological safety as a foundational element to change, apply to our educational practice:
Creating the right environment for learning requires psychological safety so learners do not lose motivation when they encounter setbacks. Setting expectations, having forums for timely debriefing and feedback, and redesigning projects to implement those changes are practical manifestations of psychological safety. Furthermore, October #HMIChat participants highlighted that educators should be discussing the process rather than focusing on the goal so learners do not get weighed down with a results-only approach. Also, learning from our failures is essential in this process. The Plan-Do-Study-Act cycle, a cornerstone of quality improvement, is one framework to accomplish that.
Applying principles of quality improvement to our healthcare education practice can help us deliver the kind of care we all hope to receive. This exchange highlights that while the definition of healthcare quality improvement can be personal there is a common conviction that patients must be at the center. There is much work to be done to further synergize the two disciplines of medical education and quality improvement. What concrete actions can you take in the next three months to incorporate quality improvement tenets into your healthcare education practices?
#HMIChat is a monthly twitter chat connecting the global community of practice focused on health professions education. Join the conversation the first Wednesday of every month! Learn more here.
Did you know that the Harvard Macy Institute Community Blog has had more than 265 posts? Previous blog posts have explored topics including Integrating Quality and Safety into the Curriculum, Bridging Leaders, and Behind the Curtain with Victoria Brazil.
Linelle Campbell, MD, is a PGY-4 Emergency Medicine Resident at Jacobi/ Montefiore. Linelle currently holds a position as Chief Resident and is a Fellow in the NYC Health + Hospital’s Healthcare Administrator Scholars Program. Linelle’s areas of professional interest include health equity, social emergency medicine and quality improvement. Linelle can be on Twitter.
Victoria Brazil, MD (Educators, ’05, Leaders ’07, Assessment ‘10) is Professor of Emergency Medicine and Director of Simulation at Bond University Faculty of Health Sciences and Medicine. Her research interests include podcasting and simulation, and she is co-producer of Simulcast - a podcast about healthcare simulation. Victoria can be followed on Twitter.
Komal Bajaj, MD, MS-HPED (Assessment ’14, Leaders ’15) is a Professor of Obstetrics & Gynecology at Albert Einstein College of Medicine. Komal currently holds a position as Chief Quality Officer and Clinical Director of Simulation at NYC Health + Hospitals/Jacobi. Komal’s areas of professional interest include the synergies between healthcare quality and simulation. Komal can be followed on Twitter.
Komal Bajaj, MD, MS-HPED (Assessment ’14, Leaders ’15,) is a Professor of Obstetrics & Gynecology at Albert Einstein College of Medicine. Komal currently holds a position as Chief Quality Officer and Clinical Director of Simulation at NYC Health + Hospitals/Jacobi. Komal’s areas of professional interest include the synergies between healthcare quality and simulation. Komal can be followed on Twitter.