title: Engaging Learners in Health System Quality Improvement Efforts.
abstract: In 1999, an Institute of Medicine report spurred health care organizations to implement systems-based quality improve ment efforts and tackle patient safety. Simultaneously, the Accreditation Council for Graduate Medical Education asked residency programs to address Practice-Based Learning and Systems-Based Practice competencies. Medical educators now advocate incorporation of these competencies in undergraduate medical education.The authors examine the success of these efforts both from the health care delivery and systems perspective as well as from the perspective of educators as they aspire to engage medical students and residents in these domains. The authors argue that the missing element that prevents health care systems from the full realization of the promise of quality improvement is bidirectional alignment. Included are examples from the literature to demonstrate how medical educators are moving toward alignment of learners with health system quality improvement and safety needs. Finally, the authors explore business and information technology governance literature in support of the hypothesis that bidirectional alignment should be the next step in moving from reactive to proactive systems of care.
authors.affiliation: K. Johl is associate program director, Internal Medicine Residency, Department of Internal Medicine, University of California, Davis Health System and School of Medicine, Sacramento, California. R.K. Grigsby is senior director, Member Organizational Development, Association of American Medical Colleges, Washington, DC.
authors.forename: Karnjit
authors.initials: K
authors.lastname: Johl
authors.forename: R Kevin
authors.initials: RK
authors.lastname: Grigsby
mesh_terms: D003479:Curriculum; D003695:Delivery of Health Care; D004503:Education, Medical, Graduate / Q000379:methods*; D004504:Education, Medical, Undergraduate / Q000379:methods*; D006801:Humans; D011361:Professional Competence; D058996:Quality Improvement; D013597:Systems Analysis