R. L. Hoffman1, E. Bailey1, J. B. Morris1, R. R. Kelz1 1Hospital Of The University Of Pennsylvania,Philadelphia, PA, USA
Introduction: The integration of quality improvement and patient safety (QIPS) knowledge within surgical educational has been limited by competing priorities, generational attitudes, and knowledge intimidation. The morbidity and mortality (M&M) conference is a shared educational space already structured around QIPS, and therefore, may lend itself to the addition of an educational moment to benefit all levels of learners. The aim of this study was to evaluate the incorporation of a brief, structured QI presentation during the M&M conference on learner satisfaction and QIPS knowledge.
Methods: Every 8 weeks over the course of one academic year, six 5-7 minute presentations, each on a different QIPS topic pertinent to the institution, were included as part of an “interesting case” rotation during M&M at one large academic training program. The “quality minute” included presentations on outcome measures (eg.,catheter-associated urinary tract infections), processes of care (eg.,enhanced recovery protocols), and measurement concepts (eg., O/E ratio). Each presentation included education of a fundamental QIPS skill or method (e.g., DMAIC) highlighting the application at the institution level. At the conclusion of the year, all attendees were invited to participate in an 8 item survey to assess the impact of the “QI minute” on their understanding of the language and concepts of QI.
Results:There were an average of 73 attendees at each conference; 35 faculty (47.9%), 28 residents (38.4%), 7 (9.6%) advanced practice providers (APP) and 3 (4.1%) fellows. The overall response rate was 62.1% (45); 65.7% (23) for faculty, 64.3% (18) for residents, 42.9% (3) for APP, and 1 identified as “other.” Overall, 82.2% (37) of respondents agreed that the “quality minute” was a positive addition to the M&M conference, 77.8% (35) agreed that they learned valuable information on QIPS methodology, 73.3% (33) agreed that the dialogue around QIPS was increased, and 64.4% (29) had a better understanding of the data behind quality reporting. There were no significant differences in level of agreement between residents and faculty. Qualitative assessment of free text items (13 comments) on the best part of the QI minute revealed 4 main themes: Increased dialogue (5), relevance to practice (5), time (4), clarity of presentation (2). Regarding areas for improvement, 15 comments addressed 5 themes: topics (6), desire for increased frequency (4), desire for increased divisional participation (2) and time (1).
Conclusion:The addition of a short, structured QI presentation during M&M conference provided an opportunity to educate faculty, trainees and APP in QIPS and provided a shared forum for increased dialogue that was positively received. The integration of the QIPS minute into the M&M conference enhanced the overall QIPS engagement within the department.