Medical errors are the third leading cause of death in the United States—as rising physicians, we can improve this statistic. In order to effect change as the next generation of healthcare providers, we must be equipped with the necessary resources. This requires us to critically assess the operating procedures that we follow and effectively collaborate with interdisciplinary teams of health professionals to optimize healthcare delivery. Creating opportunities to take such action is the cornerstone of the Larner College of Medicine at the University of Vermont and Jeffords Institute Performance Improvement Collaborative (UVM PIC).
The UVM PIC is an initiative for medical students to gain experiential learning opportunities through a diverse array of research and shadowing positions on interprofessional quality improvement (QI) and patient safety (PS) teams. These teams are comprised of physicians, nurses, and systems engineers, just to name a few, working on approximately 150 different projects at any given time throughout every department at UVM Medical Center. They focus on a range of topics, such as patient throughput in the emergency department, population health and coordination of care in the greater Burlington area, and reducing hospital-acquired infections in the inpatient population. Students can select from a myriad of offerings to match their clinical interests with performance improvement initiatives. We then connect them with the project teams so that they can play a role in whatever capacity both the student and team see fit. This can be a deeply integrated role developing a quality improvement project longitudinally, or simply shadowing the different team members in various stages of the project to understand how QI/PS manifests in our healthcare system.
Why is this work important? Understanding the fundamental basis of disease and how to treat patients is essential, and emphasized throughout undergraduate medical education, but this cannot operate efficiently or effectively if the systems in place do not mitigate the costs of healthcare, ensure that the correct protocols are adhered to, and underscore on-going clinician involvement in performance optimization. These practices ensure that healthcare teams are able to adapt to the dynamic landscape of medicine. Our educational models are beginning to integrate patient safety and quality improvement: The Liaison Committee on Medical Education responsible for U.S. accreditation of M.D.-awarding institutions requires QI/PS courses, but has no guidelines to facilitate oversight. There is limited evidence that current educational models have clinical benefits thus far, yet residency programs require competency in meeting six discrete clinical quality standards of care.
I am extraordinarily passionate about the work that my team and I have done in establishing this collaborative and bridging the gap between undergraduate and graduate medical education, as well as integrating the incredible resources of Jeffords and UVM Medical Center with the Larner College of Medicine. I became interested in performance improvement when an unparalleled opportunity stumbled into my lap to pursue a Master of Engineering in Healthcare Systems Engineering after graduating from Lehigh University in 2014. I was a neuroscience major with no engineering experience, but was intrigued by the opportunity to understand the healthcare system through a different lens before applying to medical school. Sometimes it is truly the opportunities that we do not plan for, but choose to seize, that shape our future and our passions—and this was entirely the case for me. In a difficult, accelerated year of learning about streamlining the healthcare field, reforming the financial structure of our hospitals, and then working as a systems engineer in an academic healthcare network, I became invested in the grave importance of performance improvement—and how it is truly the future of healthcare.
Upon matriculating at UVM, I helped found the Larner College of Medicine’s Institute for Healthcare Improvement Open School Chapter—SQIPS. Through interdisciplinary work, SQIPS seeks to advance and supplement medical student education with QI/PS academia and experiences—ranging from a patient safety simulation series run in the clinical simulation lab, to a medical errors panel with physicians, nurses, and lawyers. Now we have the unique opportunity, and immense interest from students, in taking this one step further and intertwining our medical students with our hospital network for firsthand exposure in performance improvement. We hope that this collaborative mutually impacts both project teams and students, compelling them to drive change and to be proponents of continuous improvement in our hospital network and the healthcare system as a whole.
If you have any questions about the Institute for Healthcare Improvement Open School, I serve as the Northeast Regional Leader and can happily answer emails at ne.ihi.openschooL@gmail.com. If you would like to apply for the UVM PIC (a one page form!), simply email UVM.PIC@gmail.com and we will work with you to find the project that suits you best!