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Early Experiences After Adopting a Quality Improvement Portfolio Into the Academic Advancement Process

Sehgal, Niraj L. MD, MPH; Neeman, Naama MSc; King, Talmadge E. MD

doi: 10.1097/ACM.0000000000001213
Innovation Reports

Problem: Academic medical centers (AMCs) and their academic departments are increasingly assuming leadership in the education, science, and implementation of quality improvement (QI) and patient safety efforts. Fostering, recognizing, and promoting faculty leading these efforts is challenging using traditional academic metrics for advancement.

Approach: The authors adapted a nationally developed QI portfolio, adopted it into their own department’s advancement process in 2012, and tracked its utilization and impact over the first two years of implementation.

Outcomes: Sixty-seven QI portfolios were submitted with 100% of faculty receiving their requested academic advancement. Women represented 60% of the submitted portfolios, while the Divisions of General Internal Medicine and Hospital Medicine accounted for 60% of the submissions. The remaining 40% were from faculty in 10 different specialty divisions. Faculty attitudes about the QI portfolio were overwhelmingly positive, with 83% agreeing that it “was an effective tool for helping to better recognize faculty contributions in QI work” and 85% agreeing that it “was an effective tool for elevating the importance of QI work in our department.”

Next Steps: The QI portfolio was one part of a broader effort to create opportunities to recognize and support faculty involved in improvement work. Further adapting the tool to ensure that it complements—rather than duplicates—other elements of the advancement process is critical for continued utilization by faculty. This will also drive desired dissemination to other departments locally and other AMCs nationally who are similarly committed to cultivating faculty career paths in systems improvement.

N.L. Sehgal is professor of medicine, Department of Medicine, and vice president and chief quality officer, UCSF Health, University of California, San Francisco, San Francisco, California.

N. Neeman is executive advisor, Monash Health, Melbourne, Australia.

T.E. King is professor, Department of Medicine, and dean, School of Medicine, University of California, San Francisco, San Francisco, California.

Funding/Support: None reported.

Other disclosures: None reported.

Ethical approval: Reported as not applicable.

Previous presentations: N.L. Sehgal presented the QI portfolio as part of a webinar presentation for the Association of American Medical Colleges’ Integrating Quality Initiative entitled “Advancing Quality and Safety into the Academic Mission,” May 2013; T.E. King presented their QI portfolio as part of a plenary presentation for the Association of Professors of Medicine entitled “Choosing Wisely Implementation and Faculty Promotion Based on Quality/Safety,” Coral Gables, Florida, February 2014.

Correspondence should be addressed to Niraj L. Sehgal, UCSF School of Medicine, 533 Parnassus Ave., Box 0131, San Francisco, CA 94143; telephone: (415) 476-0723; e-mail:

© 2017 by the Association of American Medical Colleges