How to embed quality improvement into medical training

BMJ . (2022). How to embed quality improvement into medical training. 376. e055084

This article describes an approach which applies evidence about successful quality improvement training to a curriculum on healthcare improvement for doctors in their first two years of training, drawing on the authors’ experiences. The article recommends principles to help integrate quality improvement into medical training.

What you need to know

• From the start, medical training should involve identifying problems, analysing why they happen, and testing change
• Enable interprofessional learning by focusing on problems identified by multiprofessional clinical teams
• Support requires clinical and educational leadership, and individual support such as coaching

Workplace based learning programmes on healthcare improvement in the undergraduate and foundation year (FY) curriculum. Foundation years are the first two years of postgraduate training

How to embed quality improvement into medical training

[Webinar] Using health data to improve outcomes for patients

Eventrbrite & Office for National Statistics |n.d | Using health data to improve outcomes for patients

Hosted by ONS’ Data Science Campus and Health Analysis Team, this brand-new seminar series is an exciting opportunity to hear about recent developments in health data science, to generate ideas, and to help build the health data science community

The seminars provide a dedicated space for data scientists, policymakers, health professionals, academics, epidemiologists, statisticians and other members of the data science community to come together to explore the potential of data science to improve health and health policy.

At this seminar you will hear from Dr Adam Steventon, who is Director of Data Analytics at the Health Foundation. Adam will be presenting on “Using health data to improve outcomes for patients”

Abstract

Adam will be talking about how NHS and social care organisations can be using data more effectively to improve services, and the steps that national organisations, academia and industry can be taking to support that endeavour. Adam will look back at the last twenty years to draw out some of the lessons, analyse current strategy and make some recommendations for the future.

Seminar will be held Thu, 17 February 2022 15:00 – 16:15 GMT

Booking and further information from Eventbrite (free, but requires registration)

HQIP: New resources available for trainee doctors

Health Quality Improvement Partnership | December 2021 | New resources available for trainee doctors

Trainee doctors now have access to a range of information to help them navigate quality improvement (QI) via a dedicated section of the HQIP website.

The resources for trainee doctors webpage has everything trainees need to help them carry out clinical audits or QI projects, including a Top Tips document to help them understand the ways in which they can get involved with national clinical audits.

There is also a brand new eLearning package, providing key information about NCAPOP and how trainees can get use the programme to support improvement. The course has two modules and covers a range of topics such as how to find National Clinical Audits, how to prioritise topics, accessing data and much more.

These new resources are the brainchild of former Clinical Fellow, Dr Hannah Wright, as part of a project to improve awareness of the National Clinical Audit and Patient Outcomes Programme (NCAPOP) amongst trainee doctors.

Full details are available from HQIP’s dedicated webpage

The Future Doctor Programme: A co-created vision for the future clinical team

Health Education England | July 2020| The Future Doctor Programme: A co-created vision for the future clinical team

The Future Doctor sets us a collective challenge to make a fundamental shift in medical
education from a system that places disproportionate value on specialism to one
that recognises crucial value in a generalist training; that better equips doctors in the
management of complex care, co-morbidities, and provides a deep connection and
understanding of the communities doctors serve; and instils strong professionalism
from the start of medical education and training (Source: HEE)

Image source: hee.nhs.uk

See also:

Future Doctor A co-created vision for the future clinical team.

Future Doctor Co-Created Vision – FINAL (.pdf)

Digital literacy important for delivering better & safer care

Our TEL Programme is excited to be working in partnership with the Royal College of Nursing (RCN) on some of our digital literacy work | HEE

Image source: HEE

The RCN has endorsed our work to date and are working with us on promoting the widest use across the health and care landscape of our definition of digital literacy and the digital capabilities that sit within that definition. Our latest document, ‘Improving digital literacy’, published today, explains what digital literacy is and why it is important.

Ian Cumming, our Chief Executive, and Janet Davies, RCN’s Chief Executive and General Secretary, have written the foreword for the joint document which outlines:

• Why digital capabilities are so important in the provision of the best care
• Why the right digital knowledge, skills, behaviours and attitudes are important and relevant to each and all of us working in health and care
• What those digital capabilities are
• Work undertaken to date on the digital literacy programme of work.

The document also highlights the RCN’s focus on developing digital capabilities in the nursing and midwifery workforce and why this will bring tangible benefits to citizens and patients.

• Overview
• Report

Promoting Evidence-Based Practice at a Primary Stroke Center

Promoting a culture of evidence-based practice within a health care facility is a priority for health care leaders and nursing professionals; however, tangible methods to promote translation of evidence to bedside practice are lacking | Dimensions of Critical Care Nursing

Objectives: The purpose of this quality improvement project was to design and implement a nursing education intervention demonstrating to the bedside nurse how current evidence-based guidelines are used when creating standardized stroke order sets at a primary stroke center, thereby increasing confidence in the use of standardized order sets at the point of care and supporting evidence-based culture within the health care facility.

Discussion: This nurse education strategy increased RNs’ confidence in ability to explain the path from evidence to bedside nursing care by demonstrating how evidence-based clinical practice guidelines provide current evidence used to create standardized order sets. Although further evaluation of the intervention’s effectiveness is needed, this educational intervention has the potential for generalization to different types of standardized order sets to increase nurse confidence in utilization of evidence-based practice.

Full reference: Case, C.A. (2017) Promoting Evidence-Based Practice at a Primary Stroke Center: A Nurse Education Strategy. Dimensions of Critical Care Nursing. 36(4) pp. 244–252

Knowledge transfer partnership programme announced

Knowledge Transfer Partnership announced at CSO Conference ‘Bringing Science and Innovation to the Heart of the NHS’

NHS England is set to launch its first Knowledge Transfer Partnership Programme, a 12 month development programme, aimed at clinical leaders in healthcare science.  Successful applicants who secure a place will work with other leading healthcare scientists and build long-term collaborations across clinical, research and industry sectors, whilst identifying new approaches to measuring improved outcomes, ultimately for NHS patients.

Medical school tripled GP trainee output after raising exposure to general practice

The University of Cambridge medical school more than tripled its output of GP trainees in 2016 after implementing measures to give students and F2 doctors greater exposure to general practice | GP Online

Giving medical students and junior doctors more exposure to general practice placements could give a real boost to interest in GP careers, the outcome suggests.

For F2 leavers in 2016, almost a quarter (22%) of those who graduated from the University of Cambridge and went directly into further training opted to begin GP training, according to official data.

Just one year before, in 2015, the university had the lowest proportion of F2s entering GP training in the England, at just 7%.

Read the full news article here

Education and training for sepsis

Health Education England has published Getting it right: the current state of sepsis education and training for healthcare staff across England.

Image source: http://www.hee.nhs.uk

The purpose of this report is to provide a broad understanding of the current provision of sepsis education and training for healthcare staff across England. The report includes examples of good and innovative practice in sepsis training and highlights high quality educational resources which could be promoted nationally for use in sepsis training.

Social media as a tool for antimicrobial stewardship

Pisano, J. et al (2016) American Journal of Infection Control. 44(11) pp. 1231–1236

Highlights

• Medical trainees can be engaged through the use of social media.
• Social media can be used to increase awareness and use of educational tools.
• Clinical pathway use increased through increased awareness and periodic reminders.
• Antibiotic knowledge increased as a result of following our program on social media.

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Abstract

Background: To increase the reach of our antimicrobial stewardship program (ASP), social media platforms, Facebook and Twitter, were used to increase internal medicine residents’ (IMRs’) antibiotic (Abx) knowledge and awareness of ASP resources.

Methods: Fifty-five of 110 (50%) IMRs consented to participate; 39 (71%) completed both pre- and postintervention surveys and followed our ASP on social media. Along with 20 basic Abx and infectious diseases (IDs) questions, this survey assessed IMR awareness of ASP initiatives, social media usage, and attitudes and beliefs surrounding Abx resistance. Over 6 months, IMRs received posts and Tweets of basic Abx/IDs trivia while promoting use of educational tools and clinical pathways on our ASP Web site. To compare pre- and postsurvey responses, McNemar test or Stuart-Maxwell test was used for categorical variables, and paired t test or Wilcoxon signed-rank test was used for continuous variables, as appropriate.

Results: Of the IMRs, 98% and 58% use Facebook and Twitter, respectively. To compare pre- and postintervention, median scores for Abx knowledge increased from 12 (interquartile range, 8-13) to 13 (interquartile range, 11-15; P = .048); IMRs knowing how to access the ASP Web site increased from 70% to 94%. More IMRs indicated that they used the clinical pathways “sometimes, frequently, or always” after the intervention (33% vs 61%, P = .004).

Conclusions: Social media is a valuable tool to reinforce ASP initiatives while encouraging the use of ASP resources to promote antimicrobial mindfulness.

Read the abstract here