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Training Interprofessional Teams of Students and Health Professionals in Quality Improvement ABSTRACT TITLE: Training Interprofessional Teams of Students and Health Professionals in Quality Improvement BACKGROUND: In 2006, University of Missouri Health Care began jointly training health care students and professionals in quality improvement (QI) skills, as members of interprofessional teams. OBJECTIVE: Determine if: (1) health care students perceive value from participating in interprofessional QI team training, and (2) health care improvement skills increase as a result of this experience. METHODS: Each team included health care workers, students, and at least one QI facilitator. Large group interactive learning sessions which focused on fundaments of QI process were complemented by small group work on an improvement project over a five month period. Improvement project results were presented to health system leaders at the end of training. RESULTS: Twenty-four teams comprised of 147 unique individuals (81 health care workers and 66 students) completed this training from 2006-2010. Satisfaction with the training was high, with participants expressing agreement that the training developed their QI skills, helped them gain a greater understanding of teamwork in health care, and helped them appreciate contributions of other health professionals. Student skills in QI, as assessed by the QIKAT 1 , increased as a result of the training, and were significantly better than QI skills in control groups of students who did not complete the QI training. CONCLUSIONS: Health care students trained in the improvement of health care as part of interprofessional teams view the process as valuable. Their QI skills improve significantly following the experience. NEXT STEPS: Replication of this model at other academic health centers should be considered. _______________________________________ Ogrinc, Greg; Linda A Headrick; Laura J Morrison; Tina Foster. Teaching and assessing resident competence in practice-based learning and improvement. J Gen Intern Med 19:496-500; 2004. Leslie W. Hall, MD, FACP 1,2 ; Kristin Hahn-Cover, MD, FACP, 1 ; Mary Lou Cole, MAE 1 ; Jack Gay, MD, FACOG 1 ; Julie Brandt, PhD 2 1 University of Missouri – Columbia, School of Medicine; 2 University of Missouri – Columbia, Center for Health Care Quality OBJECTIVE METHODS (cont.) CONCLUSIONS RESULTS (cont.) For additional information please contact: Leslie Hall, MD Dept of Internal Medicine University of Missouri – Columbia [email protected] BACKGROUND 0 2 4 6 8 10 12 2006-2007 2007-2008 M ean qualityim provem ent skill level m easured byQ I Know ledgeAssessm ent Tool (Q IKAT) Precourse-participating m edical students Postcourse-participating m edical students Postcourse-control m edical students precourse Q IKA T not offered '06 -'07 University of Missouri Health Care (MUHC) and University of Missouri – Columbia, School of Medicine began participating in the Achieving Competence Today (ACT) program in 2004. Supported by the Robert Wood Johnson Foundation and Partnerships for Quality Education, resident physicians and graduate nursing students received training in quality improvement. In 2006, the program was broadened to jointly train a variety of health care students and health system workers from MUHC in quality improvement skills. Determine if health professional students placed on improvement teams would value the experiential learning environment and interprofessional collaboration. Determine if completion of the training, in the context of completing a mentored QI project, would significantly increase QI skills. Large group interactive learning sessions, in which multiple teams learned QI skills together, were supplemented by facilitated individual team meetings focused on improvement projects. Participant satisfaction was assessed with an end-of-course survey, using a 5 point Likert scale. Student QI skills were assessed using the QI Knowledge Assessment Tool (QI KAT), with blinded review by two QI experts. Participating student results were compared to control students who did not complete the training. Statistical significance was provided using a Wilcoxon Rank Sum Test, with significant p-value set at < 0.05. METHODS Clinical departments wishing to host inter-professional improvement teams were identified. Departments provided learners (medical, nursing, or pharmacy). Focus of improvement work negotiated with system quality office. Other health professionals added to team, based upon focus area. Representative improvement team, which included attending physicians, nurses, a pharmacist, and fourth year medical students. RESULTS Over four years, 24 teams participated, comprised of 147 unique individuals (81 health system workers and 66 students). QI skills, measured by the QI KAT, increased from baseline values following the training (p<0.001) and were higher in trainees compared with control students (p<0.0001 in 2006-2007 and p<0.0005 in 2007-2008) Satisfaction with the training was very high: Questions about the "ACT" Experience Data from 95 respondents who completed the program between 2006- 2010 Mean Score (1=Strongly disagree to 5=Strongly Agree) Helped to develop QI skills 4.43 Helped to develop safety skills 4.14 Better understand teamwork 4.42 Better understand contributions of other health professionals 4.39 QI project helped learning 4.48 Collegues would benefit from similar program 4.27 IP team contributed to value of program 4.61 Health care students trained in the improvement of health care as part of interprofessional teams view the process as valuable. Their QI skills improve significantly following the experience. Replication of the process at other academic health centers should be considered. Examples of projects completed: Decreased wait times for Assessment Unit admits Improved EMR health maintenance documentation Improved use of palliative care order sets Improved diabetic education in primary care clinic Timely well baby nursery discharges Improved inpatient point-of-care glucose testing

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Page 1: Training Interprofessional Teams of Students and Health Professionals in Quality Improvement

Training Interprofessional Teams of Students and Health Professionals in Quality Improvement

ABSTRACT

TITLE: Training Interprofessional Teams of Students and

Health Professionals in Quality Improvement

BACKGROUND: In 2006, University of Missouri Health Care began jointly training health care students and professionals in quality improvement (QI) skills, as members of interprofessional teams.

OBJECTIVE: Determine if: (1) health care students perceive value from participating in interprofessional QI team training, and (2) health care improvement skills increase as a result of this experience.

METHODS: Each team included health care workers, students, and at least one QI facilitator. Large group interactive learning sessions which focused on fundaments of QI process were complemented by small group work on an improvement project over a five month period. Improvement project results were presented to health system leaders at the end of training.

RESULTS: Twenty-four teams comprised of 147 unique individuals (81 health care workers and 66 students) completed this training from 2006-2010. Satisfaction with the training was high, with participants expressing agreement that the training developed their QI skills, helped them gain a greater understanding of teamwork in health care, and helped them appreciate contributions of other health professionals. Student skills in QI, as assessed by the QIKAT1, increased as a result of the training, and were significantly better than QI skills in control groups of students who did not complete the QI training.

CONCLUSIONS: Health care students trained in the improvement of health care as part of interprofessional teams view the process as valuable. Their QI skills improve significantly following the experience.

NEXT STEPS: Replication of this model at other academic health centers should be considered.

_______________________________________

Ogrinc, Greg; Linda A Headrick; Laura J Morrison; Tina Foster. Teaching and assessing resident

competence in practice-based learning and improvement. J Gen Intern Med 19:496-500; 2004.

Leslie W. Hall, MD, FACP1,2; Kristin Hahn-Cover, MD, FACP,1; Mary Lou Cole, MAE1; Jack Gay, MD, FACOG1; Julie Brandt, PhD2

1University of Missouri – Columbia, School of Medicine; 2University of Missouri – Columbia, Center for Health Care Quality

OBJECTIVE

METHODS (cont.)

CONCLUSIONS

RESULTS (cont.)

For additional information please contact: Leslie Hall, MD Dept of Internal Medicine University of Missouri – Columbia [email protected]

BACKGROUND

0

2

4

6

8

10

12

2006-2007 2007-2008

Mean quality improvement skill level measured by QI Knowledge Assessment

Tool (QIKAT)

Precourse-participating medical students

Postcourse-participating medical students

Postcourse-control medical students

pre

cou

rse

QIK

AT

no

t o

ffe

red

'06

-'07

University of Missouri Health Care (MUHC) and University of Missouri – Columbia, School of Medicine began participating in the Achieving Competence Today (ACT) program in 2004. Supported by the Robert Wood Johnson Foundation and Partnerships for Quality Education, resident physicians and graduate nursing students received training in quality improvement.

In 2006, the program was broadened to jointly train a variety of health care students and health system workers from MUHC in quality improvement skills.

Determine if health professional students placed on improvement teams would value the experiential learning environment and interprofessional collaboration.

Determine if completion of the training, in the context of completing a mentored QI project, would significantly increase QI skills.

Large group interactive learning sessions, in which multiple teams learned QI skills together, were supplemented by facilitated individual team meetings focused on improvement projects.

Participant satisfaction was assessed with an end-of-course survey, using a 5 point Likert scale.

Student QI skills were assessed using the QI Knowledge Assessment Tool (QI KAT), with blinded review by two QI experts. Participating student results were compared to control students who did not complete the training. Statistical significance was provided using a Wilcoxon Rank Sum Test, with significant p-value set at < 0.05.

METHODS

Clinical departments wishing to host inter-professional improvement teams were identified. Departments provided learners (medical, nursing, or pharmacy). Focus of improvement work negotiated with system quality office. Other health professionals added to team, based upon focus area.

Representative improvement team, which included attending physicians, nurses, a pharmacist, and fourth year medical students.

RESULTS

Over four years, 24 teams participated, comprised of 147 unique individuals (81 health system workers and 66 students).

QI skills, measured by the QI KAT, increased from baseline values following the training (p<0.001) and were higher in trainees compared with control students (p<0.0001 in 2006-2007 and p<0.0005 in 2007-2008)

Satisfaction with the training was very high:

Questions about the "ACT" Experience – Data from 95 respondents who completed the

program between 2006-2010

Mean Score (1=Strongly disagree to

5=Strongly Agree)

Helped to develop QI skills 4.43Helped to develop safety skills 4.14Better understand teamwork 4.42Better understand contributions of other health professionals 4.39QI project helped learning 4.48

Collegues would benefit from similar program 4.27

IP team contributed to value of program 4.61

Health care students trained in the improvement of health care as part of interprofessional teams view the process as valuable. Their QI skills improve significantly following the experience. Replication of the process at other academic health centers should be considered.

Examples of projects completed:• Decreased wait times for Assessment Unit admits• Improved EMR health maintenance documentation• Improved use of palliative care order sets• Improved diabetic education in primary care clinic• Timely well baby nursery discharges• Improved inpatient point-of-care glucose testing• Improved clinic smoking cessation counseling