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Using Medical Student Quality Improvement Projects to Promote Evidence-Based Care in the Emergency Department

INTRODUCTION: The Association of American Medical Colleges’ (AAMC) initiative for Core Entrustable Professional Activities for Entering Residency includes as an element of Entrustable Professional Activity 13 to “identify system failures and contribute to a culture of safety and improvement.” We set...

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Autores principales: Manning, Michael W., Bean, Eric W., Miller, Andrew C., Templer, Suzanne J., Mackenzie, Richard S., Richardson, David M., Bresnan, Kristin A., Greenberg, Marna R.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Department of Emergency Medicine, University of California, Irvine School of Medicine 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5785185/
https://www.ncbi.nlm.nih.gov/pubmed/29383073
http://dx.doi.org/10.5811/westjem.2017.9.35163
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author Manning, Michael W.
Bean, Eric W.
Miller, Andrew C.
Templer, Suzanne J.
Mackenzie, Richard S.
Richardson, David M.
Bresnan, Kristin A.
Greenberg, Marna R.
author_facet Manning, Michael W.
Bean, Eric W.
Miller, Andrew C.
Templer, Suzanne J.
Mackenzie, Richard S.
Richardson, David M.
Bresnan, Kristin A.
Greenberg, Marna R.
author_sort Manning, Michael W.
collection PubMed
description INTRODUCTION: The Association of American Medical Colleges’ (AAMC) initiative for Core Entrustable Professional Activities for Entering Residency includes as an element of Entrustable Professional Activity 13 to “identify system failures and contribute to a culture of safety and improvement.” We set out to determine the feasibility of using medical students’ action learning projects (ALPs) to expedite implementation of evidence-based pathways for three common patient diagnoses in the emergency department (ED) setting (Atrial fibrillation, congestive heart failure, and pulmonary embolism). METHODS: These prospective quality improvement (QI) initiatives were performed over six months in three Northeastern PA hospitals. Emergency physician mentors were recruited to facilitate a QI experience for third-year medical students for each project. Six students were assigned to each mentor and given class time and network infrastructure support (information technology, consultant experts in lean management) to work on their projects. Students had access to background network data that revealed potential for improvement in disposition (home) for patients. RESULTS: Under the leadership of their mentors, students accomplished standard QI processes such as performing the background literature search and assessing key stakeholders’ positions that were involved in the respective patient’s care. Students effectively developed flow diagrams, computer aids for clinicians and educational programs, and participated in recruiting champions for the new practice standard. They met with other departmental clinicians to determine barriers to implementation and used this feedback to help set specific parameters to make clinicians more comfortable with the changes in practice that were recommended. All three clinical practice guidelines were initiated at consummation of the students’ projects. After implementation, 86% (38/44) of queried ED providers felt comfortable with medical students being a part of future ED QI initiatives, and 84% (26/31) of the providers who recalled communicating with students on these projects felt they were effective. CONCLUSION: Using this novel technique of aligning small groups of medical students with seasoned mentors, it is feasible for medical students to learn important aspects of QI implementation and allows for their engagement to more efficiently move evidence-based medicine from the literature to the bedside.
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spelling pubmed-57851852018-01-30 Using Medical Student Quality Improvement Projects to Promote Evidence-Based Care in the Emergency Department Manning, Michael W. Bean, Eric W. Miller, Andrew C. Templer, Suzanne J. Mackenzie, Richard S. Richardson, David M. Bresnan, Kristin A. Greenberg, Marna R. West J Emerg Med Online Manuscript INTRODUCTION: The Association of American Medical Colleges’ (AAMC) initiative for Core Entrustable Professional Activities for Entering Residency includes as an element of Entrustable Professional Activity 13 to “identify system failures and contribute to a culture of safety and improvement.” We set out to determine the feasibility of using medical students’ action learning projects (ALPs) to expedite implementation of evidence-based pathways for three common patient diagnoses in the emergency department (ED) setting (Atrial fibrillation, congestive heart failure, and pulmonary embolism). METHODS: These prospective quality improvement (QI) initiatives were performed over six months in three Northeastern PA hospitals. Emergency physician mentors were recruited to facilitate a QI experience for third-year medical students for each project. Six students were assigned to each mentor and given class time and network infrastructure support (information technology, consultant experts in lean management) to work on their projects. Students had access to background network data that revealed potential for improvement in disposition (home) for patients. RESULTS: Under the leadership of their mentors, students accomplished standard QI processes such as performing the background literature search and assessing key stakeholders’ positions that were involved in the respective patient’s care. Students effectively developed flow diagrams, computer aids for clinicians and educational programs, and participated in recruiting champions for the new practice standard. They met with other departmental clinicians to determine barriers to implementation and used this feedback to help set specific parameters to make clinicians more comfortable with the changes in practice that were recommended. All three clinical practice guidelines were initiated at consummation of the students’ projects. After implementation, 86% (38/44) of queried ED providers felt comfortable with medical students being a part of future ED QI initiatives, and 84% (26/31) of the providers who recalled communicating with students on these projects felt they were effective. CONCLUSION: Using this novel technique of aligning small groups of medical students with seasoned mentors, it is feasible for medical students to learn important aspects of QI implementation and allows for their engagement to more efficiently move evidence-based medicine from the literature to the bedside. Department of Emergency Medicine, University of California, Irvine School of Medicine 2018-01 2017-12-05 /pmc/articles/PMC5785185/ /pubmed/29383073 http://dx.doi.org/10.5811/westjem.2017.9.35163 Text en Copyright: © 2018 Manning et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) License. See: http://creativecommons.org/licenses/by/4.0/
spellingShingle Online Manuscript
Manning, Michael W.
Bean, Eric W.
Miller, Andrew C.
Templer, Suzanne J.
Mackenzie, Richard S.
Richardson, David M.
Bresnan, Kristin A.
Greenberg, Marna R.
Using Medical Student Quality Improvement Projects to Promote Evidence-Based Care in the Emergency Department
title Using Medical Student Quality Improvement Projects to Promote Evidence-Based Care in the Emergency Department
title_full Using Medical Student Quality Improvement Projects to Promote Evidence-Based Care in the Emergency Department
title_fullStr Using Medical Student Quality Improvement Projects to Promote Evidence-Based Care in the Emergency Department
title_full_unstemmed Using Medical Student Quality Improvement Projects to Promote Evidence-Based Care in the Emergency Department
title_short Using Medical Student Quality Improvement Projects to Promote Evidence-Based Care in the Emergency Department
title_sort using medical student quality improvement projects to promote evidence-based care in the emergency department
topic Online Manuscript
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5785185/
https://www.ncbi.nlm.nih.gov/pubmed/29383073
http://dx.doi.org/10.5811/westjem.2017.9.35163
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