Medical education and quality of care in the pediatric emergency department setting: a combined model

Kaddan, Walid; Poznansky, Oded; Amir, Lisa; Mimouni, Marc; Waisman, Yehezkel

doi:10.1097/01.mej.0000206195.92695.26

Cited by 8 publications

(3 citation statements)

References 18 publications

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“…Most of these had 'good' methodological quality. About half these studies showed statistically significant outcomes, specifically in improved diabetes care, preventive care measures, documentation and critical care measures [44][45][46][47][48] ; and the other half did not show statistically significant outcomes. [49][50][51][52] The least common intervention used individual projects in which the trainee worked independently.…”

Section: Description Of Studiesmentioning

confidence: 99%

Key characteristics of successful quality improvement curricula in physician education: a realist review

2014

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Purpose Quality improvement (QI) is a common competency that must be taught in all physician training programmes, yet, there is no clear best approach to teach this content in clinical settings. We conducted a realist systematic review of the existing literature in QI curricula within the clinical setting, highlighting examples of trainees learning QI by doing QI. Method Candidate theories describing successful QI curricula were articulated a priori. We searched MEDLINE (1 January 2000 to 12 March 2013), the Cochrane Library (2013) and Web of Science (15 March 2013) and reviewed references of prior systematic reviews. Inclusion criteria included study design, setting, population, interventions, clinical and educational outcomes. The data abstraction tool included categories for setting, population, intervention, outcomes and qualitative comments. Themes were iteratively developed and synthesised using realist review methodology. A methodological quality tool assessed the biases, confounders, secular trends, reporting and study quality. Results Among 39 studies, most were beforeafter design with resident physicians as the primary population. Twenty-one described clinical interventions and 18 described educational interventions with a mean intervention length of 6.58 (SD=9.16) months. Twenty-eight reported successful clinical improvements; no studies reported clinical outcomes that worsened. Characteristics of successful clinical QI curricula include attention to the interface of educational and clinical systems, careful choice of QI work for the trainees and appropriately trained local faculty. Conclusions This realist review identified success characteristics to guide training programmes, medical schools, faculty, trainees, accrediting organisations and funders to further develop educational and improvement resources in QI educational programmes.

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Section: Description Of Studiesmentioning

confidence: 99%

Key characteristics of successful quality improvement curricula in physician education: a realist review

2014

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“…In recent years, novel feedback interventions have contributed to notable improvements in patient care, quality metrics, and educational curricula throughout diverse care settings. [23][24][25][26][27][28][29][30][31][32][33][34] Furthermore, a recent Cochrane review examined the type of feedback to include and the most effective process to deliver feedback, recommending use of specific improvement plans and exchange of data between respected colleagues. 35 To our knowledge, follow-up and feedback programs related to pediatric transfers have not been described in the literature to date.…”

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confidence: 99%

Closing the Loop

Goldman

Query²,

Wong³

et al. 2020

Pediatr Emer Care

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Objectives: Follow-up and feedback foster improvement. General emergency medicine providers working in community hospitals desire follow-up and feedback on pediatric patients transferred to children's hospitals. We implemented a novel program to provide these data to our colleagues. The objective of this study was to explore stakeholder perspectives of our program.Methods: We provided secure, electronic reports on transfers from 7 general emergency departments (GEDs). Patient follow-up and feedback data were delivered to the GED's pediatric emergency care coordinator. Seven pediatric emergency care coordinators and 2 children's hospital liaisons participated in semistructured interviews. Five researchers coded and analyzed transcribed data using the constant comparative method of grounded theory. Codes were refined and clustered to develop themes.Results: Perceived values of the program included GED appreciation of closing the loop on transferred patients, providing education, and informing quality improvement. Participants valued the concise and timely nature of the reports and their empathetic delivery. Facilitators of program implementation included established professional relationships between the GED and the children's hospital liaisons and a GED's culture of selfinquiry. Barriers to program implementation included potential medicolegal exposure and the time burden for report generation and processing. Suggested programmatic improvements included focusing on generalizable, evidence-based learning points and analyzing care trends.Conclusions: Stakeholders of our pediatric posttransfer follow-up and feedback program reported many benefits and provided key suggestions that may promote successful dissemination of similar programs nationwide. Examining data trends in transferred children may focus efforts to improve the care of children across all emergency care settings.

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“…The study by Kaddan et al [4] shows that a brief daily intervention of this nature leads to incremental improvement in the knowledge of trainees and the care they provide. Furthermore, the risk management aspects of this cannot be ignored.…”

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confidence: 99%

The development of emergency medicine in Europe: from childhood to adulthood

Plunkett

2006

European Journal of Emergency Medicine

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Medical education and quality of care in the pediatric emergency department setting: a combined model

Abstract: A combined program of medical education/quality assurance-improvement in the emergency department is feasible and seems to contribute to improved medical services and patient care.

Cited by 8 publications

References 18 publications

Key characteristics of successful quality improvement curricula in physician education: a realist review

Key characteristics of successful quality improvement curricula in physician education: a realist review

Closing the Loop

The development of emergency medicine in Europe: from childhood to adulthood

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