Patient safety has always been a priority for me, but it is only recently that I became aware of the many issues that threaten quality of care for patients. As a medical student, I vividly remember shadowing at the hospital and being shocked at what I saw. I walked through patient rooms and heard loud beeps going off, the constant chatter of hospital staff, and the automatic entrance into patients’ rooms without even a knock. I wondered whether all of the disruptions and commotion impacted patient recovery in the hospital and after discharge. After pondering this, I decided that I wanted to take action and see what I, as a medical student, could do to improve daily inpatient conditions. Continue reading Improving Patient Care as a Trainee→
The Committee on Interns and Residents Policy and Education Initiative (CIR PEI) and the Society of Hospital Medicine (SHM) jointly have announced an ambitious new resident training pilot initiative specifically designed to address the gaps for which graduate medical education has been recently criticized. Resident Quality Improvement Clinics at two pilot sites, Harlem Hospital Center and Bronx-Lebanon Hospital Center, will bring learners together in multidisciplinary teams for didactic and experiential learning.
Recently in one of The Johns Hopkins Hospital’s intensive care units, a patient was dying from cancer and sepsis, and there was nothing that I, nurse Mandy Schwartz or anyone else could do to stop it. Yet as the patient’s family—two daughters and a husband—suffered at her bedside, Mandy saw their need for comfort, and she responded. Although she was busy with nursing tasks, she delved into the inner life of the patient and family. She helped the mother look as good as possible—hair combed, face washed, a clean gown and sheets. She made sure the patient was pain-free and not anxious. She hugged one daughter who was “a hugger” and avoided embracing the other daughter who wasn’t. She sat with the family, listened and supported them in their anguish.
One of the Affordable Care Act (ACA)’s main goals is to shift providers from a fee-for-service system to one that pays for performance. In October of 2014, the ACA’s third and final hospital pay-for-performance quality program will commence. The Hospital Acquired Conditions (HAC) Reductions Program will result in a 1 percent payment penalty to hospitals that score poorly on selected quality measures—estimated to be up to a quarter of institutions. Are hospitals ready for the impact of this new program? For those that are a member of the Association of American Medical College’s (AAMC) Council on Teaching Hospitals and Health Systems (COTH), the answer likely is no.
In 2009, leaders in the field of patient safety wrote about the need for physician leadership in quality and safety. They lamented a limited talent pool, insufficient training, and limited formal roles in medical schools as compared with hospitals. They advocated investment in physician-leaders in quality and safety.
By Senthil Kumar Rajasekaran, David Nierenberg, Simon Maxwell, and Kelly Karpa
Prescribing is a fundamental part of the work of new residents, who write and review many prescriptions each day. It is a complex task requiring knowledge of medicines and the diseases they are used to treat, careful judgment of risks and benefits of treatment, and attention to detail. Lack of prescribing skills among residents is widely reported. It is also apparent in other research that this is an area the new residents find challenging. Granting these new doctors prescribing privileges without adequate training and assessment can encourage poor prescribing habits and promote medication errors.
When you think of quality improvement in a medical education context, usually that means residency and other phases of graduate medical education (GME). Though there are programs rooted in medical school, usually they are introductory in nature, providing essentially a first brush with the language of quality and process improvement.
Originally posted on Educate the Young on August 5, 2013
A Day 3 tradition during the Telluride Patient Safety Educational Roundtable & Student/Resident Summer Camps has been for students and faculty to join in a team building trek up the Bear Creek trail in the San Juan mountain range of Colorado. The hike has always played an important part in the week, allowing students and faculty to collectively reflect in a relaxed, awe-inspiring environment on the conversations and concepts around patient centered care, new to some and a career choice for all. This week, the Telluride experience moved east to Washington DC, and the Bear Creek hike transformed into a crosstown journey from the Georgetown University campus on foot and Metra to theArlington National Cemetery. While the threat of bears and the physical challenges of altitude and mountain terrain were absent, the group was left to navigate east coast summer drizzle, a big-city subway system and an unfamiliar routine to overcome together. Continue reading Remembering Those Lost to Medical Harm at #TPSER9→