Improving Patient Care Outcomes by Teaching Quality Improvement to Medical Students in Community-based Practices

Gould, Bruce; Grey, Michael; Huntington, C; Gruman, Cynthia; Rosen, Jonathan H.; Storey, Eileen; Abrahamson, Lynn; Conaty, Ann Marie; Curry, Leslie; Ferreira, Michelle Amorim; Harrington, Karen; Paturzo, Deborah; Hoof, Thomas J. Van

doi:10.1097/00001888-200210000-00014

Cited by 79 publications

(62 citation statements)

References 3 publications

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“…14,17 In contrast to our study, which did not affect intermediate clinical outcomes, these interventions included additional educational components such as readings in quality of care, self-reflection, commitment to change surveys, and learner involvement in quality improvement processes. Whereas this suggests that multifaceted interventions may be beneficial, a systematic review of 85 audit and feedback studies did not find evidence that multifaceted interventions were more effective than audit and feedback alone.…”

Section: Discussionmentioning

confidence: 87%

“…6,[14][15][16][17][18] One randomized controlled trial using chart audit of 10-12 patients per resident, report cards assessing 78 audit items, and a 10-to 15-minute feedback session did not demonstrate improved patient management. 19 Possible reasons for the lack of benefit with this approach include the limited number of patients assessed per resident; diffuse nature of the feedback; and the single, brief feedback session.…”

Section: Discussionmentioning

confidence: 96%

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Use of a Registry-generated Audit, Feedback, and Patient Reminder Intervention in an Internal Medicine Resident Clinic—A Randomized Trial

Thomas

Stroebel

et al. 2007

J GEN INTERN MED

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BACKGROUND: Disease registries, audit and feedback, and clinical reminders have been reported to improve care processes. OBJECTIVE:To assess the effects of a registrygenerated audit, feedback, and patient reminder intervention on diabetes care. PARTICIPANTS: Seventy-eight categorical Internal Medicine residents caring for 483 diabetic patients participated. Residents randomized to the intervention (n=39) received instruction on diabetes registry use; quarterly performance audit, feedback, and written reports identifying patients needing care; and had letters sent quarterly to patients needing hemoglobin A1c or cholesterol testing. Residents randomized to the control group (n=39) received usual clinic education.MEASUREMENTS: Hemoglobin A1c and lipid monitoring, and the achievement of intermediate clinical outcomes (hemoglobin A1c <7.0%, LDL cholesterol <100 mg/dL, and blood pressure <130/85 mmHg) were assessed. RESULTS:Patients cared for by residents in the intervention group had higher adherence to guideline recommendations for hemoglobin A1c testing (61.5% vs 48.1%, p = .01) and LDL testing (75.8% vs 64.1%, p=.02). Intermediate clinical outcomes were not different between groups.CONCLUSIONS: Use of a registry-generated audit, feedback, and patient reminder intervention in a resident continuity clinic modestly improved diabetes care processes, but did not influence intermediate clinical outcomes.

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Section: Discussionmentioning

confidence: 87%

Section: Discussionmentioning

confidence: 96%

Use of a Registry-generated Audit, Feedback, and Patient Reminder Intervention in an Internal Medicine Resident Clinic—A Randomized Trial

Thomas

Stroebel

et al. 2007

J GEN INTERN MED

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“…[19][20][21][22][23][24][25][26][27][28][29][30][31] Several of these studies have shown an improvement in patient care as measured by specific quality indicators. The I 3 POP takes a broader approach and incorporates the triple aim for both learners and faculty development.…”

Section: Discussionmentioning

confidence: 99%

Triple Aim Is Triply Tough:

Donahue

Reid²,

Baxley

et al. 2018

Fam Med

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A ccording to leading health care experts, the US health care system needs to address the triple aim of improving the patient experience of care, the health of populations, and reducing unnecessary costs.1 Several value-based payment models are underway, including the development of Next Generation Accountable Care Organizations (ACOs), alternative payment models and merit-based incentive programs (MIPS) under the Medicare Access and CHIP Reauthorization Act (MACRA). 2,3These programs specifically include quality, cost, and patient experience and are directly impacted by primary care. These models currently target practicing clinicians; however, it is necessary to train future primary care physicians so that they are prepared to meet triple aim goals in their future practices. In response to this, faculty development initiatives are examining the transformation of primary care residency training and the clinical practice setting. 4,5With the changing landscape of primary care delivery, knowledge, and skills in assessing and impacting population health management, improving processes of care in practice settings and managing change are critical for physicians. The necessary process of measuring and improving quality in academic medical center environments, however, can prove challenging given academia's tripartite mission of research, teaching, and patient care. BACKGROUND AND OBJECTIVES: The I3 POP Collaborative sought to improve health of patients attending North Carolina, South Carolina, and Virginia primary care teaching practices using the triple aim framework of better quality, appropriate utilization, and enhanced patient experience. We examined change in triple aim measures over 3 years, and identified correlates of improvement.

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“…5 Medical students are an undervalued resource in health care organizations, and when educational providers such as the IHI Open School provide medical students with the skills and knowledge to lead improvement, they can lead change in health care. 10,22,23 Implications for Practice, Policy, and Education and Further Work Needed…”

Section: Relationship With the Literaturementioning

confidence: 99%

How Asking Patients a Simple Question Enhances Care at the Bedside: Medical Students as Agents of Quality Improvement

Ward

Kibble

Mehta

et al. 2013

TPJ

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Improving Patient Care Outcomes by Teaching Quality Improvement to Medical Students in Community-based Practices

Cited by 79 publications

References 3 publications

Use of a Registry-generated Audit, Feedback, and Patient Reminder Intervention in an Internal Medicine Resident Clinic—A Randomized Trial

Use of a Registry-generated Audit, Feedback, and Patient Reminder Intervention in an Internal Medicine Resident Clinic—A Randomized Trial

Triple Aim Is Triply Tough:

How Asking Patients a Simple Question Enhances Care at the Bedside: Medical Students as Agents of Quality Improvement

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