Despite efforts by health professional organizations to promote efforts in quality improvement, patient safety, and cost reduction, the issue remains that US medical schools and teaching hospitals do not have an adequate supply of skilled faculties to lead these efforts. Recognizing this need, an expert, multidisciplinary panel was convened by the American Association of Medical Colleges in 2012 to develop a systematic strategy to build a critical mass of academic health center faculties to lead and implement education in those three areas. In the last year, the American Association of Medical Colleges has launched a national institution-based initiative to train faculty in all clinical specialties, which includes those in obstetrics-gynecology. This comprehensive program consists of interactive experiential learning workshops, web-based resources, a national community of learners, implementation of educational initiatives, and dissemination of outcomes. Those faculties will be invaluable in leading and disseminating educational programs that embed quality improvement and patient safety across the continuum of women’s healthcare to all faculty members and residents.
The goal of medical education is to produce health care professionals who are capable of providing patient care at the highest level of evidence, quality, and safety. The Affordable Care Act and many other forces have impelled numerous changes in the education and training of medical professionals across the continuum. They include the following items:
The Problem
Many clinical faculties do not have the knowledge and skills to teach and assess learners in the emerging and vital area of health care quality improvement and patient safety.
Core recommendations
The Te4Q report describes 3 core recommendations to remedy this situation.
Recommendation 1
To achieve quality improvement and patient safety goals for education and practice, the medical schools, teaching hospitals, accreditation bodies, examination organizations, and specialty bodies should ensure the integration of quality improvement and patient safety concepts into meaningful learning experiences across the continuum of physician professional development; the summative evaluations should be used for professional certification and licensure. Of particular importance is the need for the Liaison Committee on Medical Education to require this content for medical school accreditation, which is similar to existing accreditation requirements for graduate and continuing medical education. All national examination bodies must include this content in their examinations and provide content-specific feedback to learners, medical schools, and training programs.
Recommendation 2
To improve the processes and outcomes of care, medical schools and teaching hospitals should expect all clinical faculty to be proficient in quality improvement and patient safety competencies and be able to identify, develop, and support a critical mass of faculty as expert educators to create, implement, and evaluate training and education in quality improvement and patient safety for students, residents, and colleagues. Faculty contributions in quality improvement and patient safety, whether educational, clinical, or scholarly, should be recognized as part of institutional promotion and tenure policies.
Recommendation 3
Academic and clinical leadership should share a common commitment to quality improvement and patient safety and demonstrate a concrete alignment of the academic and clinical enterprises in a manner that produces excellent health outcomes that are valued by health care professionals and the public. National organizations should expand efforts to recognize outstanding quality improvement and patient safety contributions by individuals and institutions in education and research.
Recent progress
In the last year, substantial progress has been made in accomplishing these goals. The AAMC has launched a national, institution-based, faculty development initiative, Aligning and Educating for Quality, to train expert faculty members. This comprehensive program includes an interactive experiential learning workshop, web-based resources, a national community of learners, implementation of educational initiatives, and dissemination of outcomes. Further, webinars, publications, and additional efforts from AAMC and others have enhanced sharing of successful practices in designing effective clinical learning environments across the continuum. For example, several institutions have developed and shared strategies for including quality improvement and patient safety activity in promotion and tenure criteria. The AAMC’s Aligning and Educating for Quality initiative has assisted numerous academic health centers in aligning clinical and academic leadership as new requirements in graduate and continuing medical education for quality measurement and improvement are met. A major intervention to improve this alignment has been the establishment of a Vice Chair of Quality & Patient Safety in many academic clinical departments.
The AAMC’s Research on Care Community has developed a collaborative effort of >100 institutions in clinical effectiveness and implementation science research. The AAMC’s Integrating Quality Initiative will convene its sixth national meeting this spring; the Integrating Quality iCollaborative collection in MedEdPortal offers >100 resources that have been presented at previous Integrating Quality meetings.
The Institute for Healthcare Improvement has expanded its Open School to include faculty development resources, and the number of Open School chapters in medical schools continues to rise. The Academy of Healthcare Improvement continues its efforts in fostering implementation science to enhance clinical quality research. The World Health Organization distributes their Guide to Developing a Patient Safety Curriculum in Medical Schools internationally.
It will require the sustained diligence and resources of many stakeholders to achieve the Te4Q vision that, by 2022, “US medical schools and teaching hospitals are successfully leading enormous changes in health care, aided by educational programs that embed quality improvement and patient safety across the continuum of physician development.”
The authors report no conflict of interest.
The content of this article is solely the responsibility of the authors and does not necessarily represent the official views of the Association of American Medical Colleges.
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