Scottsdale Healthcare Family Medicine Residency / Scottsdale Healthcare, Scottsdale, AZ
Development of a Multidisciplinary Quality Improvement Clinical Forum: Improving Patient Outcomes Across the Continuum of Care

Abstract

Background: Our goal was to identify a systemwide, sustainable model of integrated patient care that embraces education and patient-oriented quality measures. Objectives included (1) at least 1 family medicine resident will participate in every quarterly quality review meeting between January 2012 and April 2013; (2) family medicine chief residents and the medical director of CME will implement at least one Grand Rounds meeting quarterly between October 2012 and April 2013; (3) case review will evaluate strengths and opportunities related to integrated patient care and patient-oriented outcomes; (4) attendance at Grand Rounds will reflect multidisciplinary participation as relevant to the case review; (5) participants will demonstrate improved understanding of integrated patient care, including QI knowledge; (6) all CME and GME learning activities tied to curricular development will include quality metrics starting in November 2013.

Methods: Program activities included development of a multidisciplinary QI clinical forum that focuses on improving patient outcomes across the continuum of care, alignment of CME and GME learning activities to curricular development, and the development of quality metrics.

Results: The most successful component of our work was teamwork and identifying a high-quality sustainable educational program. The largest barrier we encountered was sustainment across the system. We worked to overcome this by involving multiple levels of the system, driven by physician leadership. We have observed integration of QI into the curriculum and GME into the QI process.

Conclusions: We have identified opportunities for improvement regarding knowledge and adoption of QI methods. Fewer than half of the participants had working competency in QI prior to the forum. Almost 90% will adopt QI methods and measures in their clinical practice. Baseline pediatric asthma quality metrics showed favorable results. In the next PDSA cycle, physician leaders will assist in defining key metrics, and we will implement quarterly project monitoring.