A Collaborative Quality Improvement Curriculum for

Internal Medicine Residents and Masters of Public Health Students:

The Lean Way

A Collaborative Quality Improvement Curriculum for

Internal Medicine Residents and Masters of Public Health Students:

The Lean WayGouri Gupte PhD, School of Public Health

Charlene Weigel MD, Department of Medicine, Mount Auburn Hospital

Winnie Suen MD, MSc, Department of Internal Medicine, Section of Geriatrics, Boston Medical Center

Gouri Gupte PhD, School of Public Health

Charlene Weigel MD, Department of Medicine, Mount Auburn Hospital

Winnie Suen MD, MSc, Department of Internal Medicine, Section of Geriatrics, Boston Medical Center

Exercise: Exercise:

• Step 1: Please watch the video

• Step 2: Please arrange the index cards (steps) in chronological order

• Step 2: Identify those steps that are not necessary to the process.

• Step 1: Please watch the video

• Step 2: Please arrange the index cards (steps) in chronological order

• Step 2: Identify those steps that are not necessary to the process.

GOALSGOALS

GOALS COMPETENCIES MET

Improve the quality and cost-effectiveness of healthcare delivery and QI education in multiple clinical microsystems at BMC

Systems-based practice- Learner will gain an appreciation of the complex system of health care and how to approach improving one piece of it.

Practice-based learning and improvement- Leaner will use self-reflection of their own practice in order to use this as a way to make improvements

Use Lean methodology principles to create a Quality Improvement curriculum for interdisciplinary teams.

Systems-based practice- Learner will gain knowledge about Lean Methodology, creation of process flow chart, how to identify ways to improve a system

Interpersonal and Communication Skills- Leaner will gain skills in working with an interdisciplinary team. Combine with MPH students

Professionalism- Learner will be accountable to and work effectively with teams- Learners will respect the interdisciplinary staff that they will be working with to gain hands on experience in a QI project

ScheduleSchedule

Session 1: Intro to QI at BMCSession 1: Intro to QI at BMC

Session1 cont’d: 4 pods x4 groups = 16 projectsSession1 cont’d: 4 pods x4 groups = 16 projects

Projects: Identified by the studentsProjects: Identified by the students

Session 2: Process MappingSession 2: Process Mapping

Session 2: Process MappingSession 2: Process Mapping

Session 3 & 4Session 3 & 4

Session 3: Identifying Wastes and Inefficiencies

Session 4: Presentations, Recommendations, Judges/Prizes

Session 3: Identifying Wastes and Inefficiencies

Session 4: Presentations, Recommendations, Judges/Prizes

Challenges: For the residents Challenges: For the residents

• TIME, TIME AND TIME

• Too many systems involved

• Very complex subject

• Resistance to change

• TIME, TIME AND TIME

• Too many systems involved

• Very complex subject

• Resistance to change

Challenges: For Public Health students Challenges: For Public Health students

• Lack of QI knowledge among residents

• Lack of awareness about systems thinking amongst residents

• Lack of time to work on QI projects

• Priority issues

• Lack of urgency for the project

• Lack of QI knowledge among residents

• Lack of awareness about systems thinking amongst residents

• Lack of time to work on QI projects

• Priority issues

• Lack of urgency for the project

Challenges: For usChallenges: For us

• No administrative support

• No funding support

• Difficult to find mentors

• Lack of sponsorship for the projects

• Limited time line

• No administrative support

• No funding support

• Difficult to find mentors

• Lack of sponsorship for the projects

• Limited time line

Main learning points for the Residents and StudentsMain learning points for the Residents and Students

• QI projects are time intensive

• There are simple, cost-effective solutions for frustrating problems

• We can change the system in a systematic way and not just whining

• Small steps can make a difference in overall process

• QI projects are time intensive

• There are simple, cost-effective solutions for frustrating problems

• We can change the system in a systematic way and not just whining

• Small steps can make a difference in overall process

Final presentationFinal presentation

• http://www.youtube.com/watch?v=bqKMeetS_lc• http://www.youtube.com/watch?v=bqKMeetS_lc

Next Steps…Next Steps…

•Further implementation and expansion of current curriculum

•Collaboration with other schools and students

•More mentors

•Longer duration program

•Taking the show on the road

•Further implementation and expansion of current curriculum

•Collaboration with other schools and students

•More mentors

•Longer duration program

•Taking the show on the road

Questions?Questions?

• Resources:

• http://sph.bu.edu/otlt/gouri_check/lean

• Resources:

• http://sph.bu.edu/otlt/gouri_check/lean

A Collaborative Quality Improvement Curriculum for Internal Medicine Residents and Masters of Public Health Students: The Lean Way

A Collaborative Quality Improvement Curriculum for Internal Medicine Residents and Masters of Public Health Students: The Lean Way

•Gouri Gupte PhD, School of Public Health, gourig@bu.edu

•Charlene Weigel MD, Department of Medicine, Mount Auburn Hospital, charlene.weigel@gmail.com

• Winnie Suen MD, MSc, Department of Internal Medicine, Section of Geriatrics, Boston Medical Center, winnie.suen@bmc.org

•Gouri Gupte PhD, School of Public Health, gourig@bu.edu

•Charlene Weigel MD, Department of Medicine, Mount Auburn Hospital, charlene.weigel@gmail.com

• Winnie Suen MD, MSc, Department of Internal Medicine, Section of Geriatrics, Boston Medical Center, winnie.suen@bmc.org