Clinician Leadership in Quality and Safety Scholarly Concentration
Casey Olm-Shipman, MD, MS
Karen Davis, MHA, MBA
Overview and Application Process
Quality Improvement and Safety is the science of improving access, cost, effectiveness, equity, and safety of the care we provide to patients. The purpose of the Clinician Leadership in Quality and Safety is to equip students with skills that they can directly apply in clinical settings as future clinicians. Learning will be longitudinal, mentored, and experiential. By the end of this on-year program, students will possess the knowledge and skills to implement a quality improvement project.
When selecting students for the program, the following is considered: student interest, completion of prerequisite work (see below) and prior QI experience, including QI projects completed during the Community Based Longitudinal Care course (CBLC). Applications received after the deadline will be considered on a case by case basis and if spots are available. Class limit is typically set at 10-12 students for the year.
Program Structure and Highlights
The prerequisites should be completed in the foundation and application phases. The program itself occurs in the individualization phase.
Foundation and Application Phase requirements:
- The following are requirements for participation in the scholarly concentration:
- Completion of the IHI open school basic certificate at http://www.ihi.org/education/IHIOpenSchool/Courses/Pages/OpenSchoolCertificates.aspx
- Attendance at the Physicians Engaged in Quality and Safety (PEQS) daylong class on the UNC campus. A PEQS class can be completed in the Community Based Longitudinal Care course (CBLC) during Application Phase year provided that the CBLC course directors are given six-week notice of a student’s interest and intention. To sign up for PEQS, you must use the UNC LMS system and search for “engagement” OR “quality.” To log into the LMS, you must use your EPIC username and password. Karen Davis can provide assistance when signing up for the class. After registering, please inform Karen Davis that you are a medical student participating.
- PDSA cycles completed during CBLC rotation or from data from a different project.
Individualization Phase requirements:
- Students conduct a quality improvement initiative over the course of the year during Individualization Phase, participating as a member of a clinical improvement team and working closely with a faculty mentor. Students meet regularly with their mentors. Mentors will be assigned by the course director with consideration to discipline. Not all disciplines have experts in quality and safety. Therefore, students may be assigned to a high-quality mentor in a similar field. Students will set a schedule with their mentors to meet regularly. Ideally, students are working on the project while participating in other electives in their chosen specialty.
- Students also attend a seminar series of 5-6 afternoon class sessions over the course of the year. Students are expected to attend class in-person to promote a learning community of active participation (a Webex option is also available for the rare circumstance in which a student is unable to attend in person).
- Students will have monthly deliverables such as project charters, AIM statements, driver diagrams, and run charts. The QI curriculum will emphasize the following key concepts:
- Improvement Methodology (LEAN, Model for Improvement)
- Driver Diagrams
- Teamwork and Leadership
- Process Modeling and Mapping
- PDSA Cycles
- Data Analysis
- Sustainability and Spread
- Presenting Data and Research
As part of the QI project experience, students join an existing improvement team. Students devote 130 hours to improvement work. Students are expected to spend time in a clinical setting interacting with patients affected by the improvement work, learning processes that might be impacted by that work, and executing tasks in support of improvement in the clinical setting in which they are working. Students will also:
- Attend project team meetings
- With guidance from mentor and project leadership, complete specific tasks as part of the overall project work
- Meet with project mentor at least monthly to plan work, reflect on learning, and seek guidance (meetings can be improvement team meetings or 1:1 with mentor or a combination)
- Meet with project mentor and course director Casey Olm-Shipman twice yearly to plan student involvement, set expectations, and assess progress
- Present results of improvement work at the student symposium in the spring.
- Prepare an abstract for submission to a conference.
“This course is the highlight (in a general sense) of my medical school experience. I wish a QI/QA training was available as a track analogous to Rural Scholars. This is the ideal curriculum for extensive longitudinal integration for the motivated, self-selected student interested in the ever-important field of Quality & Safety.”
“Most helpful part of the class is getting linked with the QI team I’m currently working with and trying this all out for myself, and learning about how QI projects work (or don’t work) in real life.”
“The best parts of this course are the collaborative efforts and support from administration. Readings are also pertinent and at a great level for beginners.”