Quality Improvement Education Incorporated as an Integral Part of Critical Care Fellows Training at the Mayo Clinic

Kashani, Kianoush B. MD; Ramar, Kannan MBBS, MD; Farmer, J. Christopher MD; Lim, Kaiser G. MD; Moreno-Franco, Pablo MD; Morgenthaler, Timothy I. MD; Dankbar, Gene C.; Hale, Curt W.

Academic Medicine:
doi: 10.1097/ACM.0000000000000398
Innovation Reports
Abstract

Problem: The Accreditation Council for Graduate Medical Education emphasizes quality improvement (QI) education in residency/fellowship training programs. The Mayo Clinic Combined Critical Care Fellowship (CCF) program conducted a pilot QI education program to incorporate QI training as a required curriculum for the 2010–2011 academic year.

Approach: CCF collaborated with the Mayo Quality Academy to customize and teach the existing Mayo Quality Fellows curriculum to the CCF fellows with the help of two quality coaches over five months starting July 2010. All fellows were to achieve Bronze and Silver certification prior to graduation. Silver required passing four written exams and submitting a health care QI project. Five projects were selected on the basis of the Impact–Effort Prioritization matrix, and DMAIC (Define, Measure, Analyze, Improve, and Control) methodology was used to complete the projects. The primary outcome was to assess learners’ satisfaction, knowledge, and skill transfer.

Outcomes: All 20 fellows were Bronze certified, and 14 (70%) were Silver certified by the time of graduation. All five QI projects were completed and showed positive impacts on patient safety and care. Surveys showed improved learner satisfaction. Graduates felt the QI training improved their QI skills and employment and career advancement. The QI curriculum had appropriate content and teaching pace and did not significantly displace other important clinical core curriculum topics.

Next Steps: The pilot was successfully implemented in the CCF program and now is in the fourth academic year as an established and integral part of the fellowship core curriculum.

Author Information

Dr. Kashani is assistant professor of medicine, College of Medicine, and consultant, Division of Nephrology and Hypertension and Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota.

Dr. Ramar is associate professor of medicine, College of Medicine, and consultant, Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota.

Dr. Farmer is professor of medicine, Department of Internal Medicine, College of Medicine, and chair, Department of Critical Care Medicine, Mayo Clinic, Scottsdale, Arizona.

Dr. Lim is associate professor of medicine, College of Medicine, and consultant, Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota.

Dr. Moreno-Franco is senior associate consultant, Division of Transplant Medicine, Department of Critical Care Internal Medicine, Mayo Clinic, Jacksonville, Florida.

Dr. Morgenthaler is associate professor of medicine, College of Medicine, and consultant, Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota.

Mr. Dankbar is senior principal health system engineer analyst, Value Creation and Diffusion Unit, Department of Systems and Procedures, Mayo Clinic, Rochester, Minnesota.

Mr. Hale is quality improvement advisor II, Quality Academy, Mayo Clinic, Rochester, Minnesota.

Funding/Support: None reported.

Other disclosures: None reported.

Ethical approval: The above study is determined to be exempt (45 CFR 46.101, item 2) from Mayo Clinic IRB review.

Supplemental digital content for this article is available at http://links.lww.com/ACADMED/A220.

Correspondence should be addressed to Dr. Kashani, Department of Internal Medicine, Mayo Clinic, Rochester, MN 55902; telephone: (507) 266-7093; e-mail: kashani.kianoush@mayo.edu.

© 2014 by the Association of American Medical Colleges