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Leveraging the Continuum: A Novel Approach to Meeting Quality Improvement and Patient Safety Competency Requirements Across a Large Department of Medicine

Myers, Jennifer S., MD; Bellini, Lisa M., MD

doi: 10.1097/ACM.0000000000002291
Innovation Reports

Problem Quality improvement (QI) and patient safety (PS) are now core competencies across the medical education continuum. A major challenge to developing and implementing these new curricular requirements is the lack of faculty expertise.

Approach In 2015, the authors developed a centralized, vertically integrated, competency-based approach to meet QI/PS educational requirements across the continuum of graduate medical education in the Department of Medicine, Perelman School of Medicine, University of Pennsylvania. By leveraging the QI/PS expertise of one individual, the authors identified and trained core QI/PS faculty members and sequentially deployed QI/PS activities that were tailored to the learner level and specialty. The curriculum includes PS event reporting, systems thinking and root causes analysis skills, adverse event disclosure, and a QI workshop series and project.

Outcomes PS event reporting, an indication of engagement in PS culture, increased by 186% among interns, 384% among postgraduate year 2 and 3 residents, and 613% among fellows between academic years (AYs) 2013–2014 and 2016–2017. In AY 2017–2018, 9 faculty members and 40 fellows from 9 fellowships participated in the QI workshop series, and 53 fellows from 7 fellowships participated in the adverse event disclosure simulation activity. All educational activities were rated highly.

Next Steps The authors are expanding the adverse event disclosure activity to include residents and the remaining fellowship programs, identifying fellowships to pilot curricular efforts related to clinical quality metrics, developing introductory activities in basic QI/PS concepts for medical students, and evaluating the impact of efforts on participating faculty members.

J.S. Myers is director, Center for Healthcare Improvement and Patient Safety, and professor and director of quality and safety education, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.

L.M. Bellini is professor and vice chair for education, Department of Medicine, and vice dean for academic affairs, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.

Funding/Support: None reported.

Other disclosures: None reported.

Ethical approval: Reported as not applicable.

Correspondence should be addressed to Jennifer S. Myers, Hospital of the University of Pennsylvania, 3400 Spruce St., Maloney Building, Suite 5033, Philadelphia, PA 19104; e-mail:

© 2018 by the Association of American Medical Colleges