Documenting Quality Improvement and Patient Safety Efforts: The Quality Portfolio. A Statement from the Academic Hospitalist Taskforce

Abstract

Physicians increasingly investigate, work, and teach to improve the quality of care and safety of care delivery. The Society of General Internal Medicine Academic Hospitalist Task Force sought to develop a practical tool, the quality portfolio, to systematically document quality and safety achievements. The quality portfolio was vetted with internal and external stakeholders including national leaders in academic medicine. The portfolio was refined for implementation to include an outlined framework, detailed instructions for use and an example to guide users. The portfolio has eight categories including: (1) a faculty narrative, (2) leadership and administrative activities, (3) project activities, (4) education and curricula, (5) research and scholarship, (6) honors, awards, and recognition, (7) training and certification, and (8) an appendix. The authors offer this comprehensive, yet practical tool as a method to document quality and safety activities. It is relevant for physicians across disciplines and institutions and may be useful as a standalone document or as an adjunct to traditional promotion documents. As the Next Accreditation System is implemented, academic medical centers will require faculty who can teach and implement the systems-based practice requirements. The quality portfolio is a method to document quality improvement and safety activities.

Research and publication trends in hospital medicine

“…Hospitalists may also perform QI that results in scholarly output other than publications (eg, grand rounds, posters, or presentations) that we did not address. In the absence of QI publications, the systematic documentation of QI efforts in a portfolio may assist career advancement …”

Recognizing Quality Improvement and Patient Safety Activities in Academic Promotion in Departments of Medicine: Innovative Language in Promotion Criteria

“…A standardized framework for the documentation of faculty members' QI/PS work, largely for promotion purposes, has been endorsed by national organizations including the APM, the Association of Chiefs and Leaders of General Internal Medicine, and the Society of General Internal Medicine. 3 It is unknown to what extent these frameworks have been adopted across institutions, but well-defined guidelines for promotion around QI/PS work can serve as a crucial adjunct for institutions seeking to honor faculty members' contributions in this realm. The innovative promotion criteria we identified provide clear means for documenting QI/ PS excellence in innovation, change management, mentorship, teaching, and leadership as well as achievement, productivity, and success.…”

“…The innovative promotion criteria we identified provide clear means for documenting QI/ PS excellence in innovation, change management, mentorship, teaching, and leadership as well as achievement, productivity, and success. 3,4 Formats should be standardized to support comparative and peer review. 3 The criteria called out here provide specific frameworks to document QI/PS activities and highlight their academic value, in alignment with what has previously been developed for clinician-educators.…”

“…3,4 Formats should be standardized to support comparative and peer review. 3 The criteria called out here provide specific frameworks to document QI/PS activities and highlight their academic value, in alignment with what has previously been developed for clinician-educators. 3,4,[26][27][28] Existing processes have elucidated the need to identify measures of success, productivity, and scholarship that expand historic definitions while maintaining academic rigor.…”

“…1,4 Although QI/PS achievements are viewed favorably by chairs of departments of medicine, traditional pathways for fostering the professional advancement, promotion, or tenure of medical school faculty members infrequently embrace these contributions. 3 In a survey of chairs of academic departments of internal medicine, the majority of respondents did not find their existing promotion criteria to be useful in assessing QI/PS work. 5 Seventy-eight percent of respondents thought it would be helpful to have guidelines for evaluating the role of QI/PS work for promotions.…”