Quality Improvement and Patient Safety (QIPS) Curriculum

The QIPS Track

Tuesday QIPS Intern School

The Chief Residents of Quality and Safety lead a Quality Improvement and Patient Safety (QIPS) curriculum for all interns. The small-group, interactive sessions occur every Tuesday of plus one week longitudinally throughout intern year. The goals of this curriculum are to develop clinical leaders who promote a culture of safety, recognize systemic vulnerabilities, and gain the skills to improve quality of care. Our current intern curriculum covers the following foundational topics:

• Introduction to QIPS
• Patient Safety Incident Reporting
• Just Culture
• Introduction to Root Cause Analysis
• Improvement Science
• Statistical Process Control and Run Charts
• Healthcare Quality Improvement Strategies

QIPS Elective

For more advanced skills in Quality Improvement and Patient Safety, residents apply to a year-long elective (one half-day during each ambulatory week) that occurs during the second year. Highlights of the elective include:

• Patient Safety Conference: Residents conduct a root cause analysis of a real patient safety event and present it to an active audience of stakeholders and colleagues.
• Resident Research & Quality Improvement (RRQI) Day Poster: Residents present their scholarly output at the annual Dr. Arti Rupani Garg Resident Research & Quality Improvement Day at Loyola University Medical Center.
• Basic Certificate in Quality & Safety: Residents earn a certificate through the completion of courses in the Institute for Healthcare Improvement's Open School on Quality and Safety.
• Self-Audit: Residents perform a self-audit of their own patient outcomes as a formal method of continued reflection with the goal of achieving individual practice changes and improved patient outcomes.
• Housestaff Quality & Safety Committee Participation: Residents contribute to an interdisciplinary forum of trainees from all disciplines to enact institutional changes impacting patient care.
• Dedicated mentorship and professional development: Residents receive mentorship from a Chief Resident of Quality and Safety and an Assistant Program Director to translate personal interests into meaningful scholarly output and the creation of a robust professional network.

QI Scholar Program

Residents may apply for up to 6 weeks of dedicated reasearch time in an academic year to work on an independent quality improvement project with a dedicated faculty mentor.

Residents receive formal LEAN training taught by an experienced Systems Redesign Program Manager at Edward Hines, Jr. VA Hospital. With completion of LEAN, residents earn a LEAN Yellow Belt Certificate.

QI scholars also submit their findings to either the High Value Practice Academic Alliance (HVPPA) national conference or another national conference of their choosing.

Applications for the QI Scholar program are held during the spring of each academic year.

QI Projects & Conference Submissions

Our residents have instigated valuable change at Loyola and Hines by participating in and even starting their own quality improvement projects. Below is just a sampling of the quality improvement projects our residents are involved in. Many have submitted their findings to local, regional and national conferences.

Recent Projects

• Improving Safety during Intra-Hospital Transfer of MICU Patients at LUMC
• Increasing Patient Understanding of Hospital Stay in Cirrhotics
• Hypothermia Protocol at Hines VA
• Phenobarbital for Alcohol Withdrawal
• Improving PFT Reads per ATS Guidelines
• Re-evaluating the Use of Contact Precautions in MRSA and VRE
• Improving Discharge Process in COPD Patients
• De-escalation of Antibiotics in Neutropenic Fever
• Get With the Guidelines Heart Failure Protocols

Recent Conference Submissions

• American College of Gastroenterology
• American College of Physicians - Illinois Chapter
• Association of VA Hematology/Oncology (AVAHO)
• High Value Practice Academic Alliance (HVPAA)
• American Thoracic Society (ATS)
• Loyola Resident Research & Quality Improvement Day

Past Projects

• Improving Hypertension Control in Hines Primary Care Clinics with M.A.P System
• Heart Failure Transitions of Care Process Redesign
• The Identification of Patient and Process Characteristics Associated with 30-day Heart Failure Readmissions at an Academic Center
• Hines EKG Notification Protocol
• ARC/ACC Diagnostic Imaging Clinical Decision Support System & Redesign
• Small-Bore Feeding Tube Task Force
• Implementation of a Discharge Summary Template to Improve Provider Documentation
• Hines Hem/Onc Service Discharge Process Redesign
• Effect of Patient Boarding on Unit vs Off Unit for Medical ICU Patients

Testimonials

“Having earned my MBA in Healthcare Leadership in medical school, I developed a taste for QI early in my medical training. The QIPS elective allowed me a chance to further my understanding of Quality Improvement & Patient Safety topics and their applications in a real-world context. Additionally, it offered a structured space in which to forge connections and relations with other members of the healthcare team striving for the same QI/PS goals. It was through these connections that I was able to develop a resident-led QI project regarding Heart Failure readmissions which was within a much larger institutional initiative aimed at reducing readmission rates at the VA. It is due to the QI Scholar track that I will be able to spend dedicated time completing this project.”

- Cat Sawalski, DO (Class of 2024)

“The QIPS elective helped me gain a better understanding of how to systematically analyze problems at their core to attempt to address them. The elective enabled me to learn the tools to create systemic changes allowing me to help provide improved patient care even for patients I had never directly managed. It also gave me the confidence to help mentor others to identify and analyze problems so they too can help address safety issues they identify.”

- Ben Follman, MD (Class of 2024)

"The QIPS elective was a great experience because it allowed me to develop a better understanding of how to improve patient care by identifying and working to fix system errors that can lead to patient harm. After completing the elective, I feel better prepared to provide safe, high-quality care to my patients."

- Michael Fayad, DO (Class of 2023)

"Finding ways to feel connected has been one of my saving graces when it comes to maintaining resiliency in residency. The QIPS elective has been one of my favorite ways to do this. It provides real-time, meaningful avenues to further my QI knowledge while thinking critically about ways to deliver safer patient care."

- Andrea Grillini, MD (Chief Resident in Quality and Safety)

"The QIPS experience provided me the knowledge and experience to identify issues regarding quality and safety affecting patient care along with the tools to address them. This allowed for a unique, well-rounded experience as a growing physician, being involved in the bedside interactions with patients while participating in the background machinations of the system that cares for them."

- Gabe Matias, MD (Class of 2023)

"Tuesday QIPS Intern School was so helpful to have as a new PGY1. It was the perfect orientation to the general field of quality & safety. We learned important terminology, analyzed patient safety cases and participated in mock scenarios with our co-interns. I learned a lot and felt encouraged to apply for the QIPS elective as a PGY2!"

- Hina Dalal, DO (Class of 2021)

"The QIPS elective has been a highlight to my residency. It taught me foundational skills that are necessary to understanding the complexity of healthcare systems and ways that we can improve delivery of patient care. I know that this is only the start of my involvement in QI work and this elective will be something I use regularly in my career."

- Nathan Yung, MD (Class of 2020)

"The QIPS elective provided a structured method to develop projects and become engaged in different QI opporutnities, such as networking, being a member of the Housestaff Quality & Safety Committee, and presenting at QI conferences. I was guided through the process who shared the same goals and taught me how to understand different situations through the quality improvement and patient safety perspective."

- Navkiran Dhillon, MD (Class of 2020)

"The QI scholar program allowed me to discover my passion for extra-clinical scholarly projects. I was able to design and conduct my own study with guidance from a faculty supervisor. The findings have guided my ongoing efforts in systemic improvement and the way we care for patients here at Loyola. It's exciteing to make an additional impact beyond what we do day-to-day at the bedside."

- Michael Belmont, MD (Class of 2020)

"The intern QIPS curriculum was a great way to learn about patient safety and analytical risk reduction methods. It was so helpful to work thorugh a real CLABSI protocol that Loyola implemented in an effort to reduce in-hospital patient line associated infections, and to see the process from beginning to end - with real results! Getting together with my firm for "Tuesday school" was also a fun way for us to bond during the plus one week!"

- Maria Latz, MD (Class of 2019)

"The QI elective has been a great supplement to my residency education. The independent study portion is flexible to fit our busy schedules, and the involvement in our Housestaff Quality and Safety Committee enables us to impact change on issues that affect residents on a day to day basis. Highly recommended!"

- Abbie Raymond, DO (Class of 2018)