Share this article on:

The Physician Mentored Implementation Model: A Promising Quality Improvement Framework for Health Care Change

Li, Jing MD, MS; Hinami, Keiki MD, MS; Hansen, Luke O. MD, MHS; Maynard, Gregory MD, MSc; Budnitz, Tina MPH; Williams, Mark V. MD

doi: 10.1097/ACM.0000000000000547
Articles

Quality improvement (QI) efforts hold great promise for improving care delivery. However, hospitals often struggle with QI implementation and fail to sustain improvement in either process changes or patient outcomes. Physician mentored implementation (PMI) is a novel approach that promotes the success and sustainability of QI initiatives at hospitals. It leverages the expertise of external physician mentors who coach QI teams to implement interventions at their local hospitals. The PMI model includes five core components: (1) a hospital self-assessment tool, (2) a face-to-face training session including direct interaction with a physician mentor, (3) a guided continuous quality improvement and systems approach, (4) yearlong individual physician mentoring, and (5) a learning community supported by a resource center, listserv, and webinars. Mentors provide content and process expertise, rather than offering “one-size-fits-all” technical assistance that might not be sustained after the mentoring year ends. Mentors support and motivate QI teams throughout the planning and implementation phases of their interventions, help to engage hospital leadership, garner local physician buy-in, and address institutional barriers. Mentors also guide hospitals to identify opportunities for the adaptation and customization of original evidence-based models of care while ensuring the fidelity of those models. More than 350 hospitals have used the PMI model to implement successful national and statewide QI initiatives. Academic medical centers are charged with improving the health of patients and reengineering care delivery; thus, they serve as the ideal source for physician mentors and can act as leaders in implementing QI projects using the PMI model.

Dr. Li is assistant professor, Department of Internal Medicine, and administrator, Center for Health Services Research, University of Kentucky, Lexington, Kentucky.

Dr. Hinami is assistant professor of medicine, Rush University School of Medicine, Chicago, Illinois.

Dr. Hansen is assistant professor of medicine, Division of Hospital Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois.

Dr. Maynard is clinical professor of medicine, Division of Hospital Medicine, University of California, San Diego, San Diego, California, and senior vice president, Society of Hospital Medicine Center for Hospital Innovation and Improvement, Philadelphia, Pennsylvania.

Ms. Budnitz is chief strategic development officer, Society of Hospital Medicine, Philadelphia, Pennsylvania.

Dr. Williams is professor and vice chair, Department of Internal Medicine, and director, Center for Health Services Research, University of Kentucky, Lexington, Kentucky.

Funding/Support: None reported.

Other disclosures: Li: honoraria from Quantia Communications, Inc. for educational presentations; Hansen: grant funding from the Society of Hospital Medicine (SHM) to Northwestern University Feinberg School of Medicine for Project BOOST and honoraria from SHM for Project BOOST; Maynard: acted as a leader of the venous thromboembolism prevention and glycemic control physician mentored implementation programs for SHM and acts as senior consultant for the SHM Center for Hospital Innovation and Improvement, honoraria for multiple grand rounds on care transitions, venous thromboembolism prevention, and inpatient glycemic control; Williams: principal investigator for Project BOOST, honoraria for multiple grand rounds and conference presentations on care transitions and for educational presentations to Quantia Communications, Inc., royalties from Elsevier for Comprehensive Hospital Medicine, grant funding from SHM to Northwestern University Feinberg School of Medicine for Project BOOST and honoraria from SHM for Project BOOST.

Ethical approval: Reported as not applicable.

Supplemental digital content for this article is available at http://links.lww.com/ACADMED/A241.

Correspondence should be addressed to Dr. Williams, Center for Health Services Research, University of Kentucky, 740 South Limestone, J525 Kentucky Clinic, Lexington, KY 40536-0596; telephone: (859) 218-1039; e-mail: mark.will@uky.edu.

© 2015 by the Association of American Medical Colleges