reprinted from Issue 13, Fall 2011 of Frontiers of Medicine (PDF)
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Last fall, the Department of Medicine launched its inaugural Quality and Safety Innovation Challenge, inviting teams of faculty and trainees to work together to improve patient care.
The Challenge drew an enthusiastic response: 29 teams from UCSF Medical Center, San Francisco General Hospital (SFGH), the San Francisco Veterans Affairs Medical Center (SFVAMC), and UCSF Fresno submitted proposals. The groups presented 24 posters at a sympo- sium held last June, and representatives from the three award-winning projects discussed their findings.
Many of the projects were already in various stages of development, a testament to how quality improvement and patient safety efforts are becoming interwoven into the curriculum. For example, third-year Parnassus Integrated Student Clinical Experiences medical students Sam Brondfield, Anisha Chandra, Steve Popper and Leslie Sheu wanted to empower hospitalized patients with limited English proficiency (LEP) to ask for a professional interpreter as part of their quality improvement course. For the Challenge, they teamed up with Saraswati Iobst, MD, a Hospital Medicine fellow, and Leah Karliner, MD, MAS, an assistant professor and expert in improving care for LEP patients.
The group developed and piloted the distribution of a yellow card, written in English and Chinese, letting patients know that they could request free inter-pretation services. “In the month we had the cards distributed to patients… we noticed an increase in both the number of calls made to the Chinese interpreting services, as well as an increase in the duration of those calls,” says Chandra.
“We’ve learned a lot,” says Iobst. “That’s what quality improvement is – you take it back into your next PDSA cycle,” referring to the repeating Plan-Do-Study-Act process, which allows groups to refine and improve interventions. “We had presented the first round of our project to our fellow students, but the Challenge was great,” said Popper. “Making the poster helped us figure out what the most important things were, and prepare for the next cycle of implementing the card.”
Other winning teams developed an easy-to-read summary of key informa-tion about patients discharged from the SFVAMC, as well as an electronic tool to increase communication between SFGH residents and primary care providers during patients’ hospitalizations. At the event, Talmadge E. King, Jr., MD, Chair of the Department of Medicine, said he is committed to finding ways to sustain such innovations after medical students and residents graduate.
Recognizing Quality Leaders in the Promotion Process
The Department of Medicine also recently established a dedicated Quality Improvement Portfolio, which allows faculty to highlight their work in systems innovation, quality improvement and patient safety as part of the promotion process.
“Serving on quality and safety task forces or improving how clinics are run are invaluable to making improve-ments, but may not always result in traditional markers of achievement like academic publications or grant funding,” says Associate Chair for Quality Improvement and Patient Safety Niraj Sehgal, MD, MPH. “In the context of health care reform, so much of that work is a function of doing system innovation and quality improvement. We want to cultivate faculty who are recognized and rewarded for leading this work.”