Advanced Curriculum Development: Creating Education Models in Practice Based Learning and Improvement and Systems Based Practice to - PowerPoint PPT Presentation

Loading...

PPT – Advanced Curriculum Development: Creating Education Models in Practice Based Learning and Improvement and Systems Based Practice to PowerPoint presentation | free to download - id: 40974e-ZTEzM



Loading


The Adobe Flash plugin is needed to view this content

Get the plugin now

View by Category
About This Presentation
Title:

Advanced Curriculum Development: Creating Education Models in Practice Based Learning and Improvement and Systems Based Practice to

Description:

Advanced Curriculum Development: Creating Education Models in Practice Based Learning and Improvement and Systems Based Practice to Geriatricize Your Environment – PowerPoint PPT presentation

Number of Views:111
Avg rating:3.0/5.0
Slides: 26
Provided by: pai4
Learn more at: http://www.pogoe.org
Category:

less

Write a Comment
User Comments (0)
Transcript and Presenter's Notes

Title: Advanced Curriculum Development: Creating Education Models in Practice Based Learning and Improvement and Systems Based Practice to


1
Advanced Curriculum Development Creating
Education Models in Practice Based Learning and
Improvement and Systems Based Practice to
Geriatricize Your Environment
Kathryn E. Callahan, MD Helen M. Fernandez, MD,
MPH Kirsten Feiereisel, MD William P. Moran, MD,
MS Paula M. Podrazik, MD Patty J. Iverson, MA
2
Objectives
  • Identify the resources, strengths, and needs in
    your home institutions educational environment
    to support the design of a PBLI/SBP curriculum
    with a geriatric focus
  • List at least 2 strengths and 2 weaknesses of
    differing curricular approaches to teaching PBLI
    and SBP
  • Generate at least 1 goal and 3 objectives for a
    curriculum in PBLI/SBP at your home institution
  • Operationalize the needs, goals, objectives,
    strengths, and weaknesses of your institutions
    educational environment to craft the basics of a
    curriculum in PBLI or SBP using geriatric content.

3
QI in Ambulatory Geriatrics
  • Implementation of the Practice Improvement Module
    for Care of the Vulnerable Elderly CoVE PIM

4
Care of the Vulnerable Elderly Practice
Improvement Module (CoVE PIM)
5
CoVE Sites
Downtown Health Plaza (IM)
Piedmont Plaza (FM)
OPD Clinic (IM)
6
Implementing the CoVE PIM
  • Phase 1 Collect practice data to evaluate
    performance measures
  • All PGY-2s perform a medical record audit on at
    least 5 older patients in their continuity clinic
    panel
  • Family Medicine- incorporated into clinic
    experience
  • Internal Medicine- incorporated into inpatient
    geriatrics
  • At least 25 patient surveys per practice
  • Submit 1 practice site survey

7
Implementing the CoVE PIM
  • Phase 2 Implement Quality Improvement Project
  • All PGY-3s review ABIM aggregate data report
  • Develop, implement and evaluate a quality
    improvement project to target deficiencies
  • One project per site

8
CoVE PIM Internal and Family Medicine
  • 2009 Cohort
  • 35 residents completed Phase Two.
  • OPD 12 residents 60 charts audited 25 patient
    surveys.
  • DHP 13 residents 65 charts audited 30 patient
    surveys.
  • FM 10 residents 60 charts audited 56 patient
    surveys.
  • 2010 Cohort
  • 38 residents completed Phase One (10 FM/28 IM).
  • Phase Two starting Fall 2011.
  • 2011 Cohort
  • 38 residents, beginning Phase One.

9
CoVE PIM, operationalized
  • IM Two teams (OPD and DHP), each with
  • 2 faculty mentors
  • 3 Resident Leaders Team Leader, Communication
    Czar, Interdisciplinary/Staff Liaison
  • Additional roles defined as project develops
    (e.g., Information Technology Liaison,
    Literature Reviewer)
  • FM Two teams, each with
  • 1 faculty mentor
  • 1 Chief Resident

10
CoVE PIM IM 2009 Cohort Impact
  • Leadership roles inspire Geriatrics interest
  • Team Leaders presented at Grand Rounds
  • Team Leaders plan Geriatrics fellowship
  • Systems-Based Practice Outcomes
  • Resident-designed Geriatrics Screening Template
    in hospital-wide EMR
  • Interdisciplinary team leadership experience
  • Practice-Based Learning Outcomes
  • I didnt realize there were guidelines for older
    adults!
  • I laminated the Falls Algorithm and posted it

11
Experiential and Longitudinal QI Curriculum for
Geriatrics Fellows
  • Didactic QI Curriculum
  • Application Practice Improvement Module for Care
    of the Vulnerable Elderly (CoVE-PIM)
  • Assessment
  • Pre- and Post-Test with the Quality Improvement
    Knowledge Application Tool (QIKAT)
  • Structured Interview with fellows
  • Audit and Feedback with mentored QI project

12
QI Curriculum
  • Institute of Healthcare Improvement
  • Courses designed by IHI self-paced
  • QI 101 Fundamentals of improvement
  • QI 102 The Model of Improvement
  • QI 103 Measuring for improvement
  • QI 104 Putting It All Together
  • QI 105 Human side of QI
  • QI 106 Level 100 tools
  • Each session duration time is from 30 minutes to
    1 hour

13
QIKAT
  • Assesses prior experience with QI
  • Three scenarios reflecting quality of care
    problem
  • Identify aim of improvement project
  • Appropriate measures
  • Desired outcome for scenario
  • Assesses attitudes
  • Does learner feel QI is essential to future
    career?
  • Does learner possess confidence in his/her
    ability to bring about change?

14
Practice Improvement Module
Holmboe et al. JCEHP 2006 26 109-19.
15
Curriculum, continued
  • Fellows reviewed the needs assessment
  • Three small groups (clinic day) presented ideas
    for QI projects
  • Single project identified (cognitive screening)
    and implemented
  • Outcomes
  • Re-measure process indicator
  • QIKAT post-test
  • Qualitative interview with fellows

16
Curriculum for the Hospitalized Aging
PatientCHAMP
  • Teaching PBLI/SBP
  • Incorporating CHAMP Teaching Tools into your
    Curriculum
  • Paula Podrazik, MD
  • Program Director, Geriatrics Fellowship
  • University of Arkansas for Medical Sciences

CHAMP developed at the University of
Chicago Supported by a D.W. Reynolds Foundation
educational grant
17
http//champ.bsd.uchicago.edu
18
Process Mapping as a teaching tool
The first step is to draw a flow diagram then
everyone understands what his job is. If people
do not see the process, they cannot improve it.
W.E. Deming, 1993
  • A process map or flowchart is a picture of the
    sequence of steps in a process as it
  • actually occurs. Can be a higher level or
    drilled-down view of the process.
  • In the health care industry useful for
  • Planning a project
  • Describing a process
  • Documenting a standard way for doing a job
  • Building consensus about the process correct
    misunderstandings
  • In resident student teaching useful for
  • Teaching about PBLI holding the mirror to
    your practice
  • Teaching about SBP-understanding the village
    that delivers care

Stat?
Patient transported
NO
Exam Completed
CT Abd. needed
EMR order
YES
Call Radiology Tech.
Process map of a clinical care issuehigher
level process view
19
Teaching Case Audit
Case Audit What is it? A structured review of
clinical care across a single patients hospital
stay ? Addresses a relevant clinical issue
? Accepted quality measures exist ? Performed by
the team ? Fits PBLI construct
Inouye S, et al. Ann Intern Med 1992
119474. Inouye S., et al. Ann Intern Med 1990
113941. Inouye S, et al. JAMA 1996 275852.
From Whelan, Podrazik, Johnson. Semin Med Pract
2005 870. Developed by Dr. Podrazik _at_
University of Chicago.
20
Teaching Census Audit
Census Audit What is it? A review of clinical
care across patients ? Addresses a focused
clinical issue ? Simple quality measures exist ?
Performed by the team ? Fits PBLI construct
From Whelan, Podrazik, Johnson. Semin Med Pract
2005 871. Developed by Dr. Whelan _at_
University of Chicago.
21
MUSCAging Q3
http//mcintranet.musc.edu/agingq3
22
Knowledge to Performance
23
Academic Detailing
Resident Cue
24
Participation
Activity Falls 9/8/09 12/14/09
Activity n ()
Faculty attending in-service 17/27 (77.8)
Residents attending didactic 37/100 (37)
Detailing encounters Detailed 86/100 (86)
Detailing encounters Skill - TUG 64/100 (64)
Teaching Attendings detailing Based on all Teaching Attendings 18/21 (85.7)
Teaching Attendings observing skill - TUG 13/15 (87)
25
EMR Template
About PowerShow.com