Physician Engagement in Quality & Safety: An Orientation to Clinical Improvement

Since 2014, over 800 residents, fellows, faculty and staff have participated in a six-hour orientation to clinical improvement and patient safety called Physician Engagement in Quality and Safety (PEQS). Designed for resident physicians by UNC’s Institute for Healthcare Quality Improvement (IHQI), PEQS is required for medical residents and appropriate for anyone seeking a foundation in clinical improvement and patient safety.

Physician Engagement in Quality & Safety: An Orientation to Clinical Improvement click to enlarge Residents engaging in discussion at a PEQS course.

Since 2014, over 800 residents, fellows, faculty and staff have participated in a six-hour orientation to clinical improvement and patient safety called Physician Engagement in Quality and Safety (PEQS). Designed for resident physicians by UNC’s Institute for Healthcare Quality Improvement (IHQI), PEQS is required for medical residents and appropriate for anyone seeking a foundation in clinical improvement and patient safety.

PEQS aims to:

  • Highlight the safety and quality challenges facing health care.

  • Explore physicians' role as leaders in improvement work.

  • Emphasize patient and family involvement in quality and safety work.

  • Build enthusiasm for participation in improvement work.

The course also helps UNC meet institutional requirements for the ACGME Clinical Learning Environment Review (CLER) Program. Although the best way to learn to improve patient care is by participating in a quality improvement initiative, this is tough for residents to do given their demanding schedules. IHQI’s orientation to quality and safety is a great starting point. The course includes a blend of presentations, small group discussions and active problem solving.

The curriculum for Physician Engagement in Quality and Safety has evolved based on participant feedback, ensuring that the most important topics are covered. Recent comments include: “Great delivery. Very relevant content that EVERY clinical provider should hear,” and, “Today had a lot of topics that I had not known about previously.”

The day begins with inspiration and motivation. After viewing Atul Gawande’s TED talk, “How to Heal Medicine,” participants explore the systems and processes they encounter daily that work well and that need improvement. The day wraps up with ways that one can get involved in QI at UNC. In between, participants learn about involving patients and family in quality and safety, how to report and disclose an adverse event, and communication methods that promote teamwork and patient safety.

Physicians leading clinical improvement initiatives at UNC teach at every session. Physicians who taught this year include Dr. Katie Westreich, who shared her project, “Improving Pediatric Discharge,” and Dr. Tom Bice, who took participants through the process of implementing his project, “Lung Protective Ventilation.”

PEQS faculty include patient and family advisors who teach participants skills for communicating with patients and families – a key component of patient safety. A recorded version of the patient and family engagement session is available at IHQI’s website. Recorded in 2018, the video features Patience Leino, a member of IHQI’s faculty and a well-respected patient and family advisor describing her experience as a parent who became a leader in quality and safety at UNC.

Dr. Shana Ratner, Associate Director of IHQI, explains the benefits of the course. “Physician Engagement in Quality and Safety gives residents an opportunity to meet other champions of QI work. Our goal is for every participant to come away with a better understanding of our systems of care and excitement about improvement work.”

At the end of each Physician Engagement in Quality and Safety course, there are more UNC residents energized to continue the important work of quality improvement. Energizing the next generation of QI champions is one way that IHQI is fulfilling its mission of “catalyzing healthcare improvement, spread and culture change by developing and mentoring clinical improvement leaders.”