Intern Rotation: "PQJ"

Residents' introduction to core principles of patient safety and quality improvement begins during internship. All interns complete a 1-month "procedures-quality" rotation, based at Moffitt-Long Hospital. During this rotation, interns spend 2 weeks learning to perform bedside procedures (such as thoracentesis, paracentesis and lumbar puncture) under the direct supervision of a specially trained faculty hospitalist. The procedures curriculum involves dedicated didactics, modules, and real-time instruction in the evidence-based evaluation of patient safety for undergoing procedures, informed consent for procedures, procedural technique, interpretation of test results, and post-procedure follow-up. Interns also receive dedicated instruction in the use of bedside ultrasound for marking fluid for thoracentesis and paracentesis.

photos by Kapo Tam

Interns also complete a second case review designed to teach principles of cost awareness in medicine, in a fashion similar to the American Board of Internal Medicine’s “Choosing Wisely” campaign. Interns are provided with an actual, anonymized billing statement for a patient with a common medical condition. They then review evidence-based guidelines for workup and treatment of this condition, compare guidelines to the actual workup performed, and identify areas where deviation from evidence-based practice may have resulted in excess costs. Their findings are summarized in a Cost Awareness noon conference for housestaff.

These experiences are supplemented by a core series of didactics on key patient safety and QI concepts, supplemented by key readings from leaders in the field.

For additional information or questions please contact:

Sumant Ranji, MD
Associate Professor of Clinical Medicine
Associate Program Director for Residency Program
(415) 514-9256; sumantr@medicine.ucsf.edu