Patient Safety and Quality Improvement Program

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University Hospitals Cleveland Medical Center and the Louis Stokes Cleveland Veteran Affairs Medical Center are dedicated to quality improvement and patient safety, and have each received awards and recognition in patient outcomes and quality clinical care. Quality improvement and patient safety will be important to all physicians’ future careers, regardless of specialty. Our Internal Medicine Residency program aims to prepare its residents for this aspect of their career with a longitudinal curriculum designed to teach the basic principles, participate in a process improvement project, and immerse trainees in the quality improvement activities at the University Hospitals Institute for Healthcare Quality and Innovation.

PGY1 Quality Curriculum

During the first year of Internal Medicine Residency training, interns will be exposed to basic principles of quality improvement and patient safety, with an emphasis on error. In the first half of the year during the primary care block, they will learn about error and how it affects individual patients and society. Then, in the second half of the year during the professional development block, interns will reflect on error that they have experienced up to that point in their residency and ways error affects providers. Throughout the year, they will complete modules from the Institute for Healthcare Improvement in order to learn terminology specific to quality improvement.

PGY2 Quality Improvement Project

In the second year of residency, each PGY2 is required to participate in a quality improvement project in a small group setting. Residents will learn tools for process improvement and get hands-on practice by applying them to their own projects. Each group will have a quality improvement mentor; under their guidance, residents are expected to work on the project throughout the course of the academic year and present their project results at the annual Department of Medicine Research Day in May. Previous resident quality improvement projects have been extremely successful and continue to be implemented in the hospital and Internal Medicine Residency program.

PGY3 Resident EQUIPS

In 2009, the Internal Medicine Residency program and the University Hospitals Institute for Healthcare Quality and Innovation collaborated to create a curriculum for a four-week externship called EQUIPS (Externship in Quality Improvement and Patient Safety). All PGY3 residents participate in this immersion experience, which includes high-yield didactics from various Quality Institute staff, including the Chief Quality Officer, William Annable, MD. Residents also review and present cases for several Quality Assurance committees and perform audits on inpatient wards focused on regulatory agency safety standards. Residents participate in a multidisciplinary leadership committee to review patient safety reports and determine if further action is warranted. The goal of the externship is for residents to gain a deeper and more nuanced understanding of patient safety and quality issues in a large teaching hospital as wells as embrace the concept of continuous quality improvement.