SURVEY RESULTS. QUESTIONS? For questions or additional information, please contact Meaghan Quinn Project Manager for Best Practices

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1 SUMMARY OF FINDINGS FROM BEST PRACTICES FOR BETTER CARE LEADERSHIP SURVEY Best Practices for Better Care (BPBC) is a national initiative jointly sponsored by the Association of American Medical Colleges and the University Healthsystem Consortium (UHC). A critical element of this effort is documenting how well quality improvement and patient safety (QI/PS) concepts and practices have been successfully integrated into medical education at the participating institutions. In Fall 211, a survey was administered to medical school leadership to assess the integration of quality improvement and patient safety concepts and practices into infrastructure, leadership, collaboration, culture, and the continuum of medical education. In addition, the survey assessed the extent of education and training around the three clinical areas targeted by the BPBC initiative (safe surgery, central line infections, and hospital readmissions). SURVEY RESULTS An online survey was administered to 19 medical school leaders. Respondents wereasked to rate aspects of the clinicalandand educational environment related to the goals of the BPBC initiative. The response rate for the survey was 65.1%, with 71 of the leaders participating. The number of respondents answering any individual question ranged from 68 to 71. QUESTIONS? For questions or additional information, please contact Meaghan Quinn (mquinn@aamc.org), Project Manager for Best Practices for Better Care, or Nancy Davis(ndavis@aamc.org), Director for Practice Based Learning and Improvement.

2 Infrastructure The infrastructure for quality and safety programs includes and organizational structure that provides the necessary data, tools and resources to support the QI/PS mission, and informs and supports the educational mission of all levels of medical education. Per rcent of res spondents 2 1 Effective QI/PS champions exist at senior levels Designated positions and roles within the organizational chart responsible for QI/PS Fully active and itegrated EHR/EMR Research resources and capacity exists to analyze GI/PS data Do not exist In planning Exist but are not widely utilized Exist and are widely utilized

3 Leadership Leaders of the healthcare system and school of medicine support the importance of quality and safety and provide leadership, mentorship, and growth opportunities for individuals working in this area. Per rcent of res spondents 2 1 Effective QI/PS champions exist at senior leadership levels Individuals and teams are accountable for quality and safety processes and outcome measures Leaders priortize quality and safety agendas Champions in clinical and educational settings exist to promote QI/PS agenda, and are supported by senior leadership Strongly disagree Somewhat disagree Somewhat agree Strongly agree

4 Collaboration Existing collaboration links the quality and safety missions of the teaching hospital with the educational missions of the medical school. Per rcent of res spondents Bidirectional communication occurs between the hospital and school Cross representation from medical school and teaching hospital occurs on operational and educational committees Educational and clinical leaders collaborate on projects with common goals Medical school and other health professions' schools collaborate on projects with common goals Never Infrequently Frequently

5 Culture The culture of your academic medical center (medical school and hospital) emphasizes the importance of quality and safety, is transparent, addresses mistakes, and values the continuous improvement process. Per rcent of res spondents Improvement ideas from the entire team are encouraged Reporting of safety events is encouraged QI/PS data and event reports are transparent throughout the organization QI/PS data are used for education and clinical purposes QI/PS successes are celebrated Strongly disagree Somewhat disagree Somewhat agree Strongly agree

6 Foundations Educational programs in QI/PS are well developed, resources, implemented, and span the educational continuum (UMS, GME, CME, and faculty development). Per rcent of res spondents QI/PS trained or knowledgeable Curriculum with standardized Facilitated experiential and/or faculty available to teach across content and educational outcomes simulation QI/PS learning the continuum in QI/PS across the continuum opportunities exist across the continuum Not implemented In planning Implemented in some areas Fully implemented Educational programs in QI/PS are developed and delivered interprofessionally whenever possible

7 UME UME teaching and curricula represent full endorsement and inclusion of QI/PS principles. pondents Perc cent of res 2 1 Fully developed QI/PS Clinical topics and clerkship Studentevaluations evaluations include Adequatenumbers of Facultyare are trained to assess curriculum exists through all QI/PS competencies in UME QI/PS competencies in UME four years of UME experiences include QI/PS topics or experiences in UME Not implemented In planning Implemented in some areas Fully implemented trained faculty are available to lead QI/PS educational programs in UME

8 GME GME teaching and curricula represent full endorsement and inclusion of QI/PS principles. Pe rcent of re spondents Fully developed QI/PS curriculum exists in all programs and specialties in GME Clinical topics are Resident evaluations QI/PS activities for Supervisors are trained Adequate numbers of taught with a QI/PS include QI/PS residents are in QI/PS teaching trained faculty are focus in GME competencies in UME integrated with methods and practice available to lead QI/PS activities for faculy and educational programs other healthcare in GME professionals Not implemented In planning Implemented in some areas Fully implemented

9 Faculty and Staff Development in QI/PS Faculty and staff members are actively engaged in educational and clinical processes which enhance their ability to practice, teach and assess learner s abilities with regards to QI/PS principles. Perce ent of resp pondents 2 1 Workshopsand other Advancedtraining in QI/PS The promotions process Opportunitiesfor Facultyare are trained in QI/PS educational experiences in has been developed and recognizes QI/PS achievements and awards teaching methods QI/PS education are made available at our achievements in some in QI/PS excellence exist at available and accessible institution fashion the division, department, or school level Not implemented In planning Implemented in some areas Fully implemented

10 CME Internal CME activities (rounds, M&M conferences, on line learning, team training) emphasize the importance of QI based on health system needs identified by institutional data. Perc cent of resp pondents Quality data are used in CME Quality data are used to assess Educational interventions are case Educational interventions are planning CME activity impact based and interactive; not didactic integrated with system changes (i.e., computerized order entry systems, reminders, etc) to reinforce change Not implemented In planning Implemented in some areas Fully implemented

11 Focus on Educational Activities (UME) BPBC initiative includes three clinical commitment areas: safe surgery, reducing central line infections, and reducing hospital readmissions. i Perce ent of resp pondents Surgicalcare care improvement: post surgical Cather related blood stream infection: Hospital discharge transitions and mortality, postoperative pulmonary embolus specifically, central line acquired blood stream readmissions: communication with primary or deep vein thrombosis, postoperative sepsis, infection, or CLABSI rate care provider; medical reconciliation; patient and postoperative wound dehiscence education; schedule follow up appointments no focus in this area needs more focus teaching is fully active

12 Focus on Educational Activities (GME) BPBC initiative includes three clinical commitment areas: safe surgery, reducing central line infections, and reducing hospital readmissions. Perce ent of resp pondents 2 1 Surgicalcare care improvement: post surgical Cather related blood stream infection: Hospital discharge transitions and mortality, postoperative pulmonary embolus specifically, central line acquired blood stream readmissions: communication with primary or deep vein thrombosis, postoperative sepsis, infection, or CLABSI rate care provider; medical reconciliation; patient and postoperative wound dehiscence education; schedule follow up appointments no focus in this area needs more focus teaching is fully active

13 Focus on Educational Activities (CME and Faculty Development) BPBC initiative includes three clinical commitment areas: safe surgery, reducing central line infections, and reducing hospital readmissions. Perce ent of resp pondents Surgicalcare care improvement: post surgical Cather related blood stream infection: Hospital discharge transitions and mortality, postoperative pulmonary embolus specifically, central line acquired blood stream readmissions: communication with primary or deep vein thrombosis, postoperative sepsis, infection, or CLABSI rate care provider; medical reconciliation; patient and postoperative wound dehiscence education; schedule follow up appointments no focus in this area needs more focus teaching is fully active