The American Journal of Medicine
Volume 122, Issue 5 , Pages 487-491 , May 2009

Addressing the Challenges in Teaching Quality Improvement

  • Gordon Mosser, MD

      Affiliations

    • Division of Health Policy and Management, School of Public Health, University of Minnesota, Minneapolis
    • Corresponding Author InformationRequests for reprints should be addressed to Gordon Mosser, MD, Division of Health Policy & Management, University of Minnesota School of Public Health, 420 Delaware St. S.E., MMC 729, Minneapolis, MN 55455
    • ,
  • Kelly K. Frisch, MD

      Affiliations

    • HealthPartners Specialty Center, St. Paul, Minn
    • Department of Internal Medicine, Regions Hospital, St. Paul, Minn
    • Internal Medicine Residency Program, Department of Medicine, University of Minnesota Medical School, Minneapolis
    • Department of Medicine, University of Minnesota Medical School, Minneapolis
    • ,
  • Paula K. Skarda, MD

      Affiliations

    • HealthPartners Specialty Center, St. Paul, Minn
    • Department of Internal Medicine, Regions Hospital, St. Paul, Minn
    • Internal Medicine Residency Program, Department of Medicine, University of Minnesota Medical School, Minneapolis
    • Department of Medicine, University of Minnesota Medical School, Minneapolis
    • ,
  • Elie Gertner, MD

      Affiliations

    • Department of Internal Medicine, Regions Hospital, St. Paul, Minn
    • Internal Medicine Residency Program, Department of Medicine, University of Minnesota Medical School, Minneapolis

References 

  1. Institute of Medicine. Building organizational supports for change. Crossing the Quality Chasm. Washington, DC: National Academy Press; 2001;111-144
  2. Leape LL, Berwick DM. Five years after To Err Is Human: what have we learned?. JAMA. 2005;293(19):2384–2390
  3. Shortell SM, Singer SJ. Improving patient safety by taking systems seriously. JAMA. 2008;299(4):445–457
  4. Batalden PB, Leach D, Swing S, et al. General competencies and accreditation in graduate medical education. Health Aff (Millwood). 2002;21(5):103–111
  5. Accreditation Council for Graduate Medical Education. Common Program Requirements: General Competencies. http://www.acgme.org/outcome/comp/GeneralCompetenciesStandards21307.pdfAccessed March 14, 2008
  6. American Board of Internal Medicine. Policies and Procedures for Certification. http://www.abim.org/pdf/publications/e47-11-2007.pdfAccessed March 14, 2008
  7. Coleman MT, Nasraty S, Ostapchuk M, et al. Introducing practice-based learning and improvement ACGME core competencies into a family medicine residency curriculum. Joint Comm J Qual Saf. 2003;29(5):238–247
  8. Ziegelstein RC, Fiebach NH. “The mirror” and “the village”: a new method for teaching practice-based learning and improvement and systems-based practice. Acad Med. 2004;79(1):83–88
  9. Ogrinc G, Headrick LA, Morrison LJ, Foster T. Teaching and assessing resident competence in practice-based learning and improvement. J Gen Intern Med. 2004;19(5):496–500
  10. Canal DF, Torbeck L, Djuricich AM. Practice-based learning and improvement: a curriculum in continuous quality improvement for surgery residents. Arch Surg. 2007;142(5):479–483
  11. Ogrinc G, Headrick LA, Mutha S, et al. A framework for teaching medical students and residents about practice-based learning and improvement, synthesized from a literature review. Acad Med. 2003;78(7):748–756
  12. Parenti CM, Lederle FA, Impola CL, Peterson LR. Reduction of unnecessary intravenous catheter use: internal medicine house staff participate in a successful quality improvement project. Arch Intern Med. 1994;154(16):1829–1832
  13. Accreditation Council for Graduate Medical Education. Program Director Guide to the Common Program requirements, Version 2. http://acgme.org/acWebsite/navPages/commonpr_documents/CompleteGuide_v2%20.pdfAccessed March 14, 2008
  14. Djuricich AM, Ciccarelli M, Swigonski NL. A continuous quality improvement curriculum for residents: addressing core competency, improving systems. Acad Med. 2004;79(10 Suppl):S65–S67
  15. Weingart SN, Tess A, Driver J, et al. Creating a quality improvement elective for medical house officers. J Gen Intern Med. 2004;19(8):861–867
  16. Leape LL. Error in medicine. JAMA. 1994;272(23):1851–1857
  17. Holmboe ES, Prince L, Green M. Teaching and improving quality of care in a primary care internal medicine residency clinic. Acad Med. 2005;80(6):571–577
  18. Lynch DC, Swing SR, Horowitz SD, et al. Assessing practice-based learning and improvement. Teach Learn Med. 2004;16(1):85–92
  19. Langley GL, Nolan KM, Norman CL, et al. The Improvement Guide: A Practical Approach to Enhancing Organizational Performance. San Francisco, CA: Jossey-Bass Publishers; 1996;3-11
  20. Accreditation Council for Graduate Medical Education. ACGME Program Requirements for Residency Education in Internal Medicine. http://acgme.org/acWebsite/downloads/RRC_progReq/140_im_07012007.pdfAccessed March 14, 2008
  21. American Board of Internal Medicine. Internal Medicine: Certification Examination Blueprint. http://www.abim.org/pdf/blueprint/im_cert.pdfAccessed March 14, 2008
  22. Liason Committee on Medical Education. Functions and Structure of a Medical School: Standards for Accreditation of Medical Education Programs Leading to the MD Degree. http://www.lcme.org/functions2007jun.pdfAccessed March 14, 2008
  23. Boonyasai RT, Windish DM, Chakraborti C, et al. Effectiveness of teaching quality improvement to clinicians: a systematic review. JAMA. 2007;298(9):1023–1037

 Funding: None.

 Conflict of Interest: None.

 Authorship: Both authors listed above had access to the data included in this article and played a role in writing this manuscript.

PII: S0002-9343(09)00096-5

doi: 10.1016/j.amjmed.2009.01.013

The American Journal of Medicine
Volume 122, Issue 5 , Pages 487-491 , May 2009

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