Improving resident engagement in quality improvement and patient safety initiatives at the bedside: the Advocate for Clinical Education (ACE).
Quality improvement (QI) and patient safety (PS) are essential competencies in residency training; however, the most effective means to engage physicians remains unclear. The authors surveyed all medicine and surgery physicians at their institution to describe QI/PS practices and concurrently implemented the Advocate for Clinical Education (ACE) program to determine if a physician-centered program in the context of educational structures and at the point of care improved performance. The ACE rounded with medicine and surgery teams and provided individual and team-level education and feedback targeting 4 domains: professionalism, infection control, interpreter use, and pain assessment. In a pilot, the ACE observed 2862 physician-patient interactions and 178 physicians. Self-reported compliance often was greater than the behaviors observed. Following ACE implementation, observed professionalism behaviors trended toward improvement; infection control also improved. Physicians were highly satisfied with the program. The ACE initiative is one coaching/feedback model for engaging residents in QI/PS that may warrant further study.
University of Washington, Seattle, WA 98104, USA. schleyer@u.washington.edu
Anneliese M
AM
Schleyer
Jennifer A
JA
Best
Lisa K
LK
McIntyre
Ross
R
Ehrmantraut
Patty
P
Calver
J Richard
JR
Goss
D002983:Clinical Competence / Q000592:standards; D003428:Cross Infection / Q000517:prevention & control; D006801:Humans; D007396:Internship and Residency / Q000379:methods* / Q000458:organization & administration; D010147:Pain Measurement / Q000379:methods / Q000592:standards; D010348:Patient Care Team / Q000458:organization & administration; D061214:Patient Safety; D010817:Physician-Patient Relations; D019095:Point-of-Care Systems / Q000458:organization & administration; D058996:Quality Improvement / Q000458:organization & administration*