Aligning institutional priorities: engaging house staff in a quality improvement and safety initiative to fulfill Clinical Learning Environment Review objectives and electronic medical record Meaningful Use requirements

Meghan R Flanagan; Carolyn C Foster; Anneliese Schleyer; Gene N Peterson; Samuel P Mandell; Kristina E Rudd; Byron D Joyner; Thomas H Payne

doi:10.1016/j.amjsurg.2015.09.006

Aligning institutional priorities: engaging house staff in a quality improvement and safety initiative to fulfill Clinical Learning Environment Review objectives and electronic medical record Meaningful Use requirements

Am J Surg. 2016 Feb;211(2):390-7. doi: 10.1016/j.amjsurg.2015.09.006. Epub 2015 Nov 10.

Authors

Meghan R Flanagan¹, Carolyn C Foster², Anneliese Schleyer³, Gene N Peterson⁴, Samuel P Mandell⁵, Kristina E Rudd⁶, Byron D Joyner⁷, Thomas H Payne⁸

Affiliations

¹ Department of Surgery, University of Washington, 1959 NE Pacific St., Seattle, WA, 98195, USA. Electronic address: [email protected].
² Department of Pediatrics, University of Washington, Seattle Children's Hospital, Seattle, WA, USA.
³ Department of Medicine, University of Washington, Seattle, WA, USA; Hospital Quality and Patient Safety, Harborview Medical Center, Seattle, WA, USA.
⁴ Department of Anesthesiology, Virginia Commonwealth University Health System, Richmond, VA, USA.
⁵ Department of Surgery, University of Washington, 1959 NE Pacific St., Seattle, WA, 98195, USA.
⁶ Department of Medicine, University of Washington, Seattle, WA, USA.
⁷ Graduate Medical Education, University of Washington, Seattle, WA, USA; Department of Urology, Seattle Children's Hospital, Seattle, WA, USA.
⁸ Department of Medicine, University of Washington, Seattle, WA, USA; Department of Health Services, University of Washington Medical Center, Seattle, WA, USA; Department of Biomedical Informatics and Medical Education, University of Washington Medical Center, Seattle, WA, USA.

PMID: 26687964
DOI: 10.1016/j.amjsurg.2015.09.006

Abstract

Background: House staff quality improvement projects are often not aligned with training institution priorities. House staff are the primary users of inpatient problem lists in academic medical centers, and list maintenance has significant patient safety and financial implications. Improvement of the problem list is an important objective for hospitals with electronic health records under the Meaningful Use program.

Methods: House staff surveys were used to create an electronic problem list manager (PLM) tool enabling efficient problem list updating. Number of new problems added and house staff perceptions of the problem list were compared before and after PLM intervention.

Results: The PLM was used by 654 house staff after release. Surveys demonstrated increased problem list updating (P = .002; response rate 47%). Mean new problems added per day increased from 64 pre-PLM to 125 post-PLM (P < .001).

Conclusions: This innovative project serves as a model for successful engagement of house staff in institutional quality and safety initiatives with tangible institutional benefits.

Keywords: Clinical Learning Environment Review; Electronic medical record; House staff; Inpatient problem list; Meaningful Use; Quality improvement.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Academic Medical Centers*
Attitude of Health Personnel
Electronic Health Records*
Female
Humans
Internship and Residency*
Male
Meaningful Use*
Organizational Objectives
Safety*