Residency Education Advancing and Changing Healthcare REACH

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Residency Education Advancing and Changing
HealthcareREACH

• Indiana University
• Educational Innovations Project

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Indianas REACH Residency Education Advancing
Changing Healthcare

• Three main initiatives
• Institutional support
• Planning Process
• Team Effort

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A Collaborative Effort

• IUSM Leadership
• Dean and Chairman
• Team of Program Directors
• Contributors and Consultants
• Chiefs, Residents, Faculty
• Stakeholders
• Clarian Health Partners, Wishard, VA,
  Regenstrief, IUMG-PC, GME office

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Bridging the Competencies and the 21st Century
Healthcare System

Leading Change
SBP
Prof
PBLI
ICS
Patients Safe
Patients First
PC
MK
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Indianas EIP - REACH

SBP
Prof
PBLI
ICS
Patients First
PC
MK
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Patients First

• Chronic Care Model with Activated Patients
  (self-management support)
• Immersion Weeks
• Ownership of a crafted patient panel
• Non-traditional patient care
• Group visits, home visits, integrated visits with
  specialists
• Experiment with technology

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Patients First - Metrics

• Disease Registries
• Physician Report Cards with Quality Indicators
• Continuous Quality Improvement Projects per site
• ACIC survey of clinic environment
• Patient Satisfaction
• Clinic staff evaluation of residents

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Indianas EIP - REACH

SBP
Prof
PBLI
ICS
Patients Safe
Patients First
PC
MK
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Patients Safe

• Inpatient Component
• On-line modules on patient safety
• Safety goals and Epidemiology of harm
• Reporting Mechanism
• Patient Safety Forum
• Drive Systems Changes to Prevent Harm
• Campus-wide

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Patients Safe - Metrics

• GME patient safety culture survey
• Reporting behavior
• Resident-championed system changes
• Handoffs
• Measure face to face time
• resident audit of each other
• Transition from Inpatient to Outpatient
• Re-admission, appointments kept

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Indianas EIP - REACH

Leading Change
SBP
Prof
PBLI
ICS
Patients Safe
Patients First
PC
MK
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Leading Change

• Resident as Mentor
• Expand success with Model for Improvement and CQI
  projects
• Grassroots Citizenship Committees
• Leadership Training

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Leading ChangeCitizenship Committees

• Wishard Action Committee
• Clarian Action Committee
• VA Action Committee
• Patient Safety Committee
• IT Committee
• Wellness Committee
• Curriculum Committee
• CQI Steering Committee
• EIP Evaluation Committee

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Leading Change - Metrics

• QI projects in faculty practice venues
• Resident satisfaction/faculty satisfaction
• Effectiveness of Committee
• Keeping minutes
• Subsequent changes in system
• Leadership 360-degree tool
• Graduate Survey

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The Challenges

• Time and Money
• Paradigm shift within an academic medical center
• Tapping into faculty expertise and commitment
• Demonstrate progress, outcomes

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REACH Team To Date
Patients First Steering Committee Noelle Sinex
and Mary Ciccarelli, co-chairs Ann Zerr Dede
Willis Angel Wilson, PGY-2 Jeff Wells,
PGY-1 Rupen Amin, PGY-2 Mike Hancock, chief Flynn
Trinity, PGY-3

• Leading Change Steering Committee
• John Black and Alex Djuricich, co-chairs
• Glenda Westmoreland
• Deb Litzelman
• Charlie Clark
• Tom Inui
• Steve Bogdewic
• Betsy Lee
• John Kohne

Delise Webber Mike Ryan Maryam Rahimi Rick
Dexter Allison Warren, PGY-1 Rayan Ihle, PGY-2
MP Kevin Tolliver, PGY-2
Patients Safe Steering Committee David Miller and
Lia Logio, co-chairs Mike Weiner Ken Klotz Rich
Frankel Brad Doebbeling Crissy Lough,
Wishard Kathryn Davies, Clarian Jane Murphy,
VA Mary Ann Payne, VA

• EIP Steering Committee
• Lisa Harris
• Tom Inui
• John Fitzgerald
• Herb Cushing
• Brad Allen
• Chris Suelzer
• Kevin Helms

Betsy Lee Pat Ebright Ranga Ramanuja Nancy
Baxter Nancy Bechtel Scott Cunningham Kathy
Rapala Peter Nalin
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REACH!