title: Educating future physicians to track health care quality: feasibility and perceived impact of a health care quality report card for medical students.
abstract: OBJECTIVE
  Quality improvement (QI) requires measurement, but medical schools rarely provide opportunities for students to measure their patient outcomes. The authors tested the feasibility and perceived impact of a quality metric report card as part of an Education-Centered Medical Home longitudinal curriculum.
  
  
  METHODS
  Student teams were embedded into faculty practices and assigned a panel of patients to follow longitudinally. Students performed retrospective chart reviews and reported deidentified data on 30 nationally endorsed QI metrics for their assigned patients. Scorecards were created for each clinic team. Students completed pre/post surveys on self-perceived QI skills.
  
  
  RESULTS
  A total of 405 of their patients' charts were abstracted by 149 students (76% response rate; mean 2.7 charts/student). Median abstraction time was 21.8 (range: 13.1-37.1) minutes. Abstracted data confirmed that the students had successfully recruited a "high-risk" patient panel. Initial performance on abstracted quality measures ranged from 100% adherence on the use of beta-blockers in postmyocardial infarction patients to 24% on documentation of dilated diabetic eye exams. After the chart abstraction assignment, grand rounds, and background readings, student self-assessment of their perceived QI skills significantly increased for all metrics, though it remained low.
  
  
  CONCLUSIONS
  Creation of an actionable health care quality report card as part of an ambulatory longitudinal experience is feasible, and it improves student perception of QI skills. Future research will aim to use statistical process control methods to track health care quality prospectively as our students use their scorecards to drive clinic-level improvement efforts.
authors: Dr. O'Neill is an MD candidate, Feinberg School of Medicine, Northwestern University, Chicago, Illinois. Dr. Henschen is an internal medicine resident, Department of Medicine, Northwestern McGaw Medical Center, Northwestern University, Chicago, Illinois. Dr. Unger is an internal medicine resident, Department of Medicine, Northwestern McGaw Medical Center, Northwestern University, Chicago, Illinois. Mr. Jansson is an MD candidate, Feinberg School of Medicine, Northwestern University, Chicago, Illinois. Ms. Unti is an MD candidate, Feinberg School of Medicine, Northwestern University, Chicago, Illinois. Mr. Bortoletto is an MD candidate, Feinberg School of Medicine, Northwestern University, Chicago, Illinois. Ms. Gleason is clinical quality leader, Clinical Quality Department, Northwestern Memorial Hospital, Chicago, Illinois. Dr. Woods is research associate professor, Center for Healthcare Studies-Institute for Public Health and Medicine, Northwestern University, Chicago, Illinois. Dr. Evans is assistant professor, Division of General Internal Medicine, Northwestern Medical Faculty Foundation, Northwestern University, Chicago, Illinois.
authors: Sean M
authors: SM
authors: O'Neill
authors: Bruce L
authors: BL
authors: Henschen
authors: Erin D
authors: ED
authors: Unger
authors: Paul S
authors: PS
authors: Jansson
authors: Kristen
authors: K
authors: Unti
authors: Pietro
authors: P
authors: Bortoletto
authors: Kristine M
authors: KM
authors: Gleason
authors: Donna M
authors: DM
authors: Woods
authors: Daniel B
authors: DB
authors: Evans
mesh_terms: D000553:Ambulatory Care / Q000592:standards*; D003479:Curriculum; D004504:Education, Medical, Undergraduate / Q000379:methods*; D004521:Educational Measurement / Q000379:methods*; D005240:Feasibility Studies; D006801:Humans; D008611:Mentors; D018802:Patient-Centered Care; D011231:Preceptorship; D011320:Primary Health Care; D058996:Quality Improvement; D013337:Students, Medical