Residents Learn to Improve Care Using the ACGME Core Competencies and Institute of Medicine Aims for Improvement: the Health Care Matrix

Quinn, Doris; Bingham, John; Garriss, G. Waldon; Dozier, E. Ashley

doi:10.4300/01.01.0020

Cited by 13 publications

(9 citation statements)

References 12 publications

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“…7 Patient care: that is compassionate, appropriate, and effective for the treatment of health problems and the promotion of health. 8 Medical knowledge: about established and evolving biomedical, clinical, and cognate sciences (e.g., epidemiological and social-behavioral) and the application of this knowledge to patient care. 9 Interpersonal and communication skills: that result in effective information exchange and teaming with patients, their families, and other health professionals.…”

Section: Casementioning

confidence: 99%

“…5,6 The healthcare matrix has since gained increasing popularity over time, and has been used to analyze various cases in psychiatry, anesthesiology, nephrology, neurology, pediatrics, obstetrics, and gynecology. [6][7][8] The healthcare matrix is particularly suited for dissecting the complex cases in palliative care because of the multitude of physical, psychosocial, logistical, professional, interdisciplinary, ethical, and legal concerns in patients with advanced diseases. In addition to quality improvement, this could be a useful tool for palliative care educational programs by helping fellows to dissect the complexity of palliative care.…”

Section: Introductionmentioning

confidence: 99%

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Assessing Patient Care in Palliative Care Using the Healthcare Matrix

Arthur

Kwon

Reddy

et al. 2013

Journal of Palliative Medicine

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The healthcare matrix is a novel assessment tool that facilitates systematic examination of patient cases using criteria established by the Accreditation Council for Graduate Medical Education and the Institute of Medicine. It is particularly useful for analyzing complex cases, although its use in the palliative care setting has not been documented. We describe here the use of the healthcare matrix to examine the healthcare encounters of a 63 year-old patient with advanced cancer. The healthcare matrix helped us to dissect the physical, psychosocial, logistical, professional, and ethical aspects of care, and to highlight multiple opportunities for quality improvement. In addition to the case example we will be discussing the advantages and disadvantages for using the healthcare matrix and its potential utility in palliative care.

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Section: Casementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Assessing Patient Care in Palliative Care Using the Healthcare Matrix

Arthur

Kwon

Reddy

et al. 2013

Journal of Palliative Medicine

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“…Although not an SBPspecific evaluation tool, the health care matrix is a diagnostic tool that incorporates all of the ACGME competencies and the Institute of Medicine aims for improvement. 40 In this study, each internal medicine resident used the matrix to analyze the care provided for one patient and presented this self-analysis to peers who provided feedback. The matrix assists the resident in identifying the systems issues that prevented the patient from receiving optimal care and generating ideas for quality improvement projects.…”

Section: Quality Improvement Projectsmentioning

confidence: 99%

Assessing Systems‐based Practice

Chen¹,

O’Sullivan

Pfennig

et al. 2012

Academic Emergency Medicine

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The conceptual definition of systems-based practice (SBP) does not easily translate into directly observable actions or behaviors that can be easily assessed. At the Academic Emergency Medicine consensus conference on education research in emergency medicine (EM), a breakout group presented a review of the literature on existing assessment tools for SBP, discussed the recommendations for research tool development during breakout sessions, and developed a research agenda based on this discussion.ACADEMIC EMERGENCY MEDICINE 19:1366-1371 © 2012 by the Society for Academic Emergency Medicine T he inclusion of systems-based practice (SBP) as one of the Accreditation Council for Graduate Medical Education (ACGME) core competencies highlights the importance of the health care system on the ability of a physician to provide competent and effective patient care.1 Physicians must be able to collaborate with other members of the health care team, consider costs when weighing risks and benefits, improve system performance by identifying system errors and implementing potential solutions, and continue to advocate for quality patient care. This set of skills is also described in the CanMEDS Physician Competency Framework as elements of the physician role as a collaborator, manager, and health advocate. Despite a recent shift in the ACGME assessment system to the Next Accreditation System, the framework for assessing milestones within the competencies still requires specific tools to assess SBP.3 Although the conceptual definition of SBP does not easily translate into observable actions or behaviors, the Council of Emergency Medicine Residency Directors (CORD) was able to develop emergency medicine (EM)-specific evaluation domains for SBP. 4 These included specific actions and behaviors that are directly observable and facilitated real-time and summative feedback. However, this set of observable behaviors did overlook some pertinent areas, such as situational awareness and participation in systems improvement. Similarly, by using the Can-MEDS roles of collaborator, manager, and health advocate, Graham et al. also developed a comprehensive list of observable actions that readily translated into assessments. 5This article summarizes the authors' review of the current assessment tools for the SBP competency used in EM and non-EM residencies, both within and outside the United States. As a result of several small group discussions during the breakout session on the assessment of observable learner performance at the 2012 Academic Emergency Medicine (AEM) consensus conference on education research in EM, we developed a research plan for assessment tool development. PROCESS AND CONSENSUSWe reviewed the literature on SBP assessment, searching the Medline and Pubmed databases by combining the terms "systems based" with "evaluat* OR assess*" and "competenc*" as well as combining "simulation" or "portfolio" with "systems based practice," yielding 156 and 309 references, respectively.

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“…2 In 2005, Doris C. Quinn and John W. Bingham developed an educational tool called the Patient Healthcare Matrix at Vanderbilt University Medical Center. 6,10 The matrix juxtaposes the 6 IOM aims and the 6 ACGME competencies. Complex patient care can be assessed and reviewed in terms of the ACGME competencies and IOM aims.…”

mentioning

confidence: 99%

“…Correspondingly, the matrix can provide a framework to identify flaws in a system, rather than faults of individuals who work in the system, to facilitate quality improvement of patient care. 6,10 A review of the literature on PubMed revealed few publications on the use of health-care matrix. 10Y14 Publications from the developers of the health-care matrix described the use in Vanderbilt University in patient case conference, morbidity and mortality conferences among both medical students and residents, in different programs including internal medicine, emergency medicine, psychiatry, anesthesiology, and plastic surgery.…”

mentioning

confidence: 99%