The Basics of the Quality In-Training Initiative (QITI) Caroline Reinke, MD MSHP Assistant Professor, Carolinas HealthCare System Best Practices in Quality and Resident Education P01 Friday July 21 st, 2017
Disclosures I love quality and resident education! I am on the QITI Advisory Board
History Surgery residency programs often struggle to educate trainees about quality in terms that are personal and germane to them as residents QITI developed to introduce residents to the concepts of quality efforts and outcomes analysis Goal: Integrate quality science and graduate surgical education
Feasibility study
Survey of Program Directors
What it is Network for collaboration across teaching institutions to facilitate the dissemination of information and guidance in the domain of quality improvement education
Monthly Conference Calls
QITI: Mission Statement A collaborative designed to bring together Academic Affiliates of the ACS NSQIP in order to integrate patient centered outcomes into surgical training and unite academic hospitals in the pursuit of optimal patient care.
Main objectives 1. Enable easy manipulation of ACS NSQIP outcomes data to provide standardized reports with benchmarking for use in graduate surgical education 2. Develop a national quality improvement curriculum tailored to the needs of the American public centered on real issues in the care of the surgical patient 3. Foster a new culture/environment across all surgical programs to teach residents to become surgeons with a quality conscience through collaboration among academic hospitals
What additional data is collected? QITI Resident: Name of the most senior resident participating in the operation QITI Team: Team of the attending surgeon on the operation QITI PGY: PGY level of the assigned resident QITI Comments: Free text field for comments that the patient shares regarding the resident participation in their surgical experience (optional)
QITI Oversight team (recommended) Resident Education Program Director and/or Associate Program Director Residency Coordinator and/or Education Coordinator NSQIP SCR NSQIP Surgeon Champion Other interested faculty Chief Residents or "NSQIP Resident Champion Database Manager/Statistician who works in the research domain
What reports are available? Hospital Outcomes and Complications Report Resident Report Outcomes Case Details Section Team Report Outcomes Case Details Section
Outcomes and Complications Report
Resident Report
Resident Report Case Details Section
Team Report
Results 318 Members Program Directors, ACS NSQIP Surgeon Champions, Surgical Case Reviewers, Residents, and Senior Medical Students 170 Institutions University based (majority), Community-based with university affiliation, Community-based, and Military based programs
Practical Quality Improvement Curriculum Disseminated at the 10th annual ACS NSQIP Conference in July 2014, New York, NY Updated Spring 2017 https://qiti.acsnsqip.org/acs_nsqip_2017_qiti_curriculum.pdf
Section I MAKING SENSE OF QUALITY FROM THE RESIDENT PERSPECTIVE Section II FUNDAMENTALS OF SURGICAL QUALITY IMPROVEMENT TOOLS Section III BUILDING A CULTURE OF SAFETY Section IV PUTTING QUALITY INTO PRACTICE Section V CREATING AN EFFICIENT SYSTEM FOR PATIENT CARE Section VI CONTINUING THE CONVERSATION: EMERGING AREAS IN QUALITY AND SAFETY
Conclusions Resident-specific and team-specific outcomes reports can be generated using the ACS NSQIP data Interest and enrollment in the QITI reflects the unmet need for a national surgical quality improvement educational initiative to satisfy ACGME milestone requirements The QITI is one which can be implemented in surgical training programs across various specialties, involving not only physicians but also nurses and quality experts within local healthcare systems
QUESTIONS?
APDS Panel