“The New Paradigm: Patient Care and Education Driven by Quality and Safety”
The EIP, or the Educational Innovations Project, is a 10-year grant provided by the Accreditation Council on Graduate Medical Education (ACGME) for the purpose of moving residency accreditation from conforming to processes to achieving meaningful outcomes; namely competent physicians.
In 2006, the Baystate Medical Center/Tufts University School of Medicine Internal Medicine Residency Program became one of 20 training sites in the country to receive an EIP grant. Our goal is to prepare residents to practice medicine today and in the future. Among other features this requires a curriculum that teaches teamwork and embraces the Quality and Safety movement. It also requires lifelong learning skills to be an essential element of training and has inspired us to blur the lines between GME and CME. Hence, we have begun to incorporate Performance Improvement Modules (PIM), which are part of the American Board of Internal Medicine (ABIM) Recertification Process into our core educational experience.
American Board of Internal Medicine (ABIM) practice improvement module (PIM)
Practice Improvement Modules, or PIMs, are web-based learning and practice self-assessment tools developed by the ABIM to assist physicians to apply quality improvement principles in practice. The hospital-based PIM allows physicians to utilize and reflect on hospital-level outcomes data for acute myocardial infarction, community acquired pneumonia (CAP), heart failure (HF), and ventilator-associated pneumonia (VAP) using Medicare published core measures. The ABIM PIMs were adapted for use by residency programs as a tool to teach and evaluate the ACGME core competencies practice-based learning and improvement (PBLI) and systems-based practice (SBP), and as a stimulus for practical application of quality improvement concepts. We decided to complete the ABIM PIMs for heart failure and pneumonia and to focus on improving the utilization of care sets among residents and hospitalists.
Another innovation of our EIP is the Tracer Experience where residents join a traditional team with the role of observing and contributing to the process of care with attention to the adherence to Clinical Practice Guidelines and standardized safety measures. During this rotation, residents follow or “trace” patients as they transition to post-acute settings to study the effectiveness of hand-overs and identify errors. They learn first-hand from these encounters and then bring back their observations to the primary team to enhance their learning as well.
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