QUALITY ASSURANCE AND THE COMPETENCIES S Giannotta 07

QUALITY ASSURANCE AND THE COMPETENCIES S. Giannotta ‘ 07

The Six Competencies • DISCIPLINE SPECIFIC + Medical Knowledge + Patient Care • GENERAL + Practice Based Learning and Improvement + Systems Based Practice + Interpersonal and Communications Skills + Professionalism

Six Steps to Developing a Competencybased Curriculum Conduct needs assessment Identify competencies addressed by this rotation or experience Write goals and objectives Determine teaching methods Determine assessment methods Determine program improvement methods

Keep in mind • Discuss what (content) and where (setting) you are teaching a particular competency • What educational experiences need to be improved? • How can we incorporate teaching the competencies into daily patient care environment?

Systems-based Practice Residents must demonstrate an awareness of and responsiveness to the larger context and system of health care and the ability to effectively call on system resources to provide optimal health care • Health care delivery system • Cost effective practice • Patient safety and advocacy/Systems causes of error

Teaching Systems Based Practice Content Setting Health care system • Different types of medical practice and delivery systems • System resources • System issues and the reduction of errors • Conducting a root cause analysis Clinical teaching Patient Safety projects Systems based approach to M & M Lectures/Seminars/Conferences Interdisciplinary Teams

Practice Based Learning and Improvement Residents must be able to investigate and evaluate their patient care practices, appraise and assimilate scientific evidence, and improve their patient care practices. • Life-long learning • Evidence based medicine • Quality improvement • Teaching skills

Teaching Practice Based Learning and Improvement (con’t) Content Setting Evidence Based Medicine Lectures/Seminars/Conferences Journal Club Research Project Clinical Teaching Skills Clinical Teaching Role Modeling Interactive Workshop

Teaching Practice Based Learning and Improvement Content Setting Self Reflection Self reflect on practice and determine improvement Quality or Practice Improvement Lectures/Seminars/Conferences Quality Improvement Project

Professionalism Residents must demonstrate professionalism, as manifested through a commitment to carrying out professional responsibilities, adherence to ethical principles, and sensitivity to a diverse patient population • Professional behavior • Ethical principles • Cultural competence

Interpersonal and Communication Skills Residents must be able to demonstrate interpersonal and communication skills that result in effective information exchange and teaming with patients, their patients families, and professional associates. • • • Communicating with patients and families Communicating with team members Scholarly Communication

TEACHING THE COMPETENCIES GENERATION 2 The resident follows me on rounds and to the OR and observes how I perform insert competency here. I observe the resident on rounds or in the OR to assess how he / she performs insert competency here.

QUALITY ASSURANCE • JCAHO • DHS • IMQ

PERFORMANCE MEASUREMENTS • Meds • Blood • Restraints • Seclusion • Infection • UR • Service Specific

DEPARTMENT OF NEUROSURGERY QUALITY ASSURANCE MEETING AGENDA • NURSING • CLINICAL PATHWAYS • UR • PATIENT SAFETY • ORYX INDICATORS • JCAHO • SURVEY • PAIN MONITORING • INFECTION CONTROL

DEPARTMENT OF NEUROSURGERY QUALITY ASSURANCE MEETING MEMBERS NEUROSURGERY ATTENDINGS NEUROSURGERY RESIDENTS NURSING ICU FLOOR INFECTION CONTROL QA MANAGER

DEPARTMENT OF NEUROSURGERY QUALITY ASSURANCE MEETING RESIDENT INITIATED PROJECTS • ADRs (Anticonvulsants) • IMAGING AVAILABILITY vs. DENIED DAYS • CHIEF RESIDENT DOCUMENTATION • DELINQUENT CHARTS • LINE INFECTION AUDIT

QA MEETING COMPETENCIES PROFESSIONALISM Commitment to responsibilities Leadership SYSTEMS BASED PRACTICE Patient Safety / Advocacy, Systems Causes of Errors PRACTICE BASED LEARNING Quality Improvement / Evidence Based Medicine INTERPERSONAL COMMUNICATION SKILLS Communication with Team Members

WHY USE Q. A. ? TEACHABLE MOMENT CONTENT / SETTING DOCUMENTATION MINUTES PORTFOLIO EVALUATION 360 FOCUSED OBSERVATION GLOBAL PERFORMANCE RATING