Through a series of reports, The Institute of Medicine has been instrumental in calling national attention to the important issue of medical errors, patient safety and quality of care. At CHOP, the responsibility of caring for the most vulnerable of patients is not taken lightly. Our residents are at the front lines of providing care and we continually strive for excellence in all aspects of that endeavor: academic, clinical, and research. In particular, the pediatric residents are the eyes and ears of the institution, in all areas of the hospital, observing systems at work at all times of day or night. Residents are in a unique position of being able to identify systems issues that may have the potential to negatively impact patient care.
Residents learn about institution-wide efforts to make CHOP the safest it can be, including use of the Hospital’s event-reporting system. Residents are also involved with Unit Partnerships, which are floor-based interdisciplinary committees focused on utilizing and implementing the model for change in improving the quality of care and patient safety on each individual floor. Residents participate in monthly, hospital-wide, interdisciplinary Safety Morbidity and Mortality Conferences.
Building on this foundation, in the ambulatory setting our residents also take advantage of the strength of our electronic medical record (EPIC) and utilize this information system solution to direct quality improvement efforts specifically at the level of their own individual practice. In addition to a PEDIAPREDD workshop on quality improvement in primary care practice, the residents take the skills and utilize them in looking critically at their own practice of primary care pediatrics, seeking ways to measure and assess that quality and improve it.
With the mentorship of a primary care preceptor, each resident designs a focused project based on a question of clinical importance to them and develops an intervention to be assessed at a future time using the power of our electronic medical record. Implementation of these skills also happens regularly during the year, as residents use the system to aid in identifying children who need seasonal interventions like the influenza vaccine or RSV prophylaxis, and, in general, aid the resident in managing their growing panel of primary care patients.
Lastly, there are new initiatives in development that will provide residents with even more of a foundation and a longitudinal experience in safety and quality improvement. These initiatives included the quality improvement (QI) concentration in the Advanced Skills Program and the development of a formalized QI curriculum.