A novel initiative contextualizing quality improvement and systems based practice in psychiatric clinical teaching settings

Abstract

Purpose: Mental health providers will be increasingly called on to lead psychiatric efforts to improve care and care redesign. The Accreditation Council for Graduate Medical Education (ACGME) in the USA requires residency programs to teach quality improvement (QI) and systems-based practice (SBP) to all trainees as part of training requirements. However, teaching QI and SBP concepts without a clinical context can be challenging with low trainee engagement. The paper aims to discuss these issues. Design/methodology/approach: The authors describe curricular redesign with a specialized educator faculty task force that aimed to create a longitudinal curriculum that integrated abstract QI concepts into clinical practice settings, and helped trainees apply SBP concepts throughout residency. In addition, the authors describe the utilization of resident prescriber profiles to contextualize clinical practice habits, and the implementation of an educational case conference series with emphasis on QI-specific educational tools such as root cause analysis (RCA). Findings: Formal resident feedback from 2016 to 2018 has demonstrated improved trainee satisfaction. The resulting curricular change has also led to a new chief resident role and sustained engagement in QI and SBP education by trainees. Research limitations/implications: The faculty task force and curricular design changes described in this paper were implemented at one large academic institution. Thus, additional assessment and research is necessary to address the generalizability of the interventions described. Originality/value: Since QI and SBP are becoming more prominent requirements for medical education accrediting bodies such as the ACGME, the innovative curricular design can benefit other residency and medical student education programs that attempt to integrate clinical practice with education incorporating QI and SBP concepts.