ABSTRACT #19

QUALITY IMPROVEMENT CURRICULUM FOR GERIATRIC AND PALLIATIVE CARE FELLOWS: A TRIPLE WIN FOR PATIENTS, LEARNERS, AND INSTITUTION

Christine Chang, Abhinav Menon, Rebecca Masutani, William Hung, Stephanie Chow, Helen Fernandez, Brijen Shah

PURPOSE AND GOALS: The Accreditation Council for Graduate Medical Education (ACGME) mandates that programs teach quality improvement (QI)/patient safety (PS) concepts and skills, and requires participation in interprofessional QI initiatives that address disparities. Programs struggle to meet this mandate due to lack of time, faculty with QI expertise and departmental investment.

METHODS: A 9-month project-based deprtamental QI curriculum was developed. It employed a flipped classroom model using online modules to teach QI concepts and four 1-2 hour protected class time in small and large group sessions to reinforce application of QI concepts. QI roadmap with resources, accountability contracts, presentation templates were created to guide project workflow. 1st year fellows worked with faculty and fellow QI coaches on departmental prioritized team-based QI projects, which were presented to the department at midterm and end-of-year. Dissemination of QI project efforts to regional and national academic meetings were encouraged.

EVALUATION PLAN: Program evaluation consisted of a prospective pre-post survey that included demographics and 8- item questionnaire on comfort with QI concepts; 3 cases from the QI Knowledge Application Tool (QIKAT) and a 2 question open ended course evaluation. QI project outcomes and dissemination were measured.

SUMMARY OF RESULTS: 50 geriatric and palliative medicine fellows worked on 12 QI initiatives from 2020-2022. 88% fellows (44) completed both PRE and POST survey. Post curriculum, 1st year fellows (37) demonstrated improved comfort with utilizing all 5 QI concept/tools (p<0.05) and improved QI knowledge (QIKAT PRE 19.1; POST 22, Paired t test p < 0.03). QI project AIMs and outcomes improved for all 12 teams. 58% (7) of QI teams submitted abstract proposals with 86% (6) acceptance for national and regional presentations. Course evaluations were positive.

REFLECTIVE CRITIQUE: Suboptimal patient metric and safety outcomes plague health systems due to medical errors, adverse events and suboptimal implementation of evidence-based prevention/treatments. A project-based QI curriculum that engages fellows in prioritized departmental QI initiatives is an effective method for teaching QI skills to fellows and a WIN for patients, learners and institution.