Best in Class Chapters Focus Group

Recording:

  1. How you determine Chapter Leadership:
  • The out-going leader has sought an incoming leader from among the chapter membership. It is usually someone who is highly involved (natural leaders tend to self-select) and stands out among the chapter crowd. If the “candidate” agrees, then there is a period where both incoming and outgoing members act as chapter leaders in order to smoothly transition between the years.
  • Had been doing QI work early on, so once the Chapter came about, leadership came to those who were already used to working with QI in the organization
  • Leadership selection is run by 2nd year medical students before they leave, who select a group of 1st years who show a lot of interest; some selection, but most is volunteer or interest based; send an email out to all the students who consistently attended events and asked who was interested in leadership positions
  • More formal leader selection process going forward; people will be nominated and there will be elections; you must complete IHI courses and show prior commitment to be eligible to lead
  • The Graduate Medical Education department was previously involved in a national initiative to improve patient care through Graduate Medical Education, so there was organizational knowledge about IHI principles. It was through this involvement that our first chapter leader surfaced. Hand picked, interested residents are approached to volunteer for the Chapter Leadership role. In addition, we look for interdisciplinary leaders to co-lead chapter activities. Chapter leaders have included an EM/IM Adm Fellow; Administrative Manager of Care Management & Outcomes(who is a graduate nursing student) and a 2nd year IM resident (who is currently developing a Quality Fellowship).
  • Make a presentation at orientation, personal outreach to those who you know are interested, and then anyone who shows interest can run for elections
  1. How/whether you have funding for your Chapter:
  • We haven’t received any funding yet. We have asked faculty advisors and external organizations (such as the Canadian Patient Safety Institute). We have currently applied to the Canadian Medical Association for funding for a student conference we hope to hold in March 2011.
  • Faculty Advisor is a VP for the local health system, so he has been able to provide funding through the health system (use faculty support and health systems connections)
  • Funding from Norwegian Medical Students Association, Norwegian Medical Association, and local student council
  • Chapter is held at a not-for profit organization, which has a budget; susceptible to government spending cuts  would have liked to do more events if the funding had not been cut
  • Christiana Care is an IndependentAcademicMedicalCenter (a hospital without a medical school affiliated). Various internal departments interested in QI will provide generous funding; we approach them on a case-by-case basis
  • Funding from student council, since they are registered as a student group; collaborate with School of Public Health to gain more funding; restrictions on what the money can be used for; if the event is university wide, they can apply to funding from the university to get more money; need to submit a budget to the student council
  • Medical School and School of Nursing have been able to fund students going to the National and International Forum and the Student Leadership Academy; funding from Scottish Patient Safety Program tap into national initiatives to look for speakers who will pay for themselves; success of Chapter has made the dean realize that they have to put more of the medical school budget into QI events for students
  1. How you get responsiveness from your members and how you recruit:
  • Several methods of recruitment are used: emailing to ListServs, going to speak in classrooms of health professions. In all these communications we follow the principles of being “short and shocking”. We create the burning platform by citing the Canadian Adverse Events Study (as many as 24,000 hospitals patients in Canada killed each year from preventable errors) and then briefly list a few of the activities we do as a chapter. We also encourage our membership to personally “advertise” the chapter to their friends and colleagues.
  • How to get responsiveness: we definitely have had some struggles with this. One big lesson is that food at events always attracts more people. (difficult when we have no funding though). But essentially we needed to create events/activities that are important to our members, and that’s what brings them out.
  • Created a PowerPoint of presentation of accomplishments and past events and presented it to all of the nursing schools; word of mouth- tell them how good it is for your CV/career to get involved with the Open School; create an elective; get faculty support for the Open School so faculty can inspire other students to get involved; speak a career event; work locally and nationally with existing conferences to recruit for the Open School
  • Our first Chapter Leader created a 12-15 minute PowerPoint presentation using Open School resources. He presented this information to many residency and nursing councils/committees. He went to about 20 residencies and departments. Also, found local quality initiatives and talked to these groups about the OpenSchool. Started putting up anexhibitor booth, with one of the Leaders or Faculty staying at the booth to answer questions. We have brochures, sign-up sheet, and interest survey at related events, such as local quality conferences/seminars. Made the OpenSchool courses part of an elective course. We have an interdisciplinary graduate-level course on quality and patient safety in which we incorporated the IHI modules. The name of the course is Achieving Competency Today (ACT): Issue in Quality, Cost, Systems, and Safety.We revamped the course content last summer and about 50 learners completed modules during the Fall 2009 and Winter 2010 courses.
  • Work with faculty to have them talk to the students about the OpenSchool; face-to-face meetings with small groups of students, orientation presentations
  • Recruit students to work on specific projects, so they feel like they are part of something important; promote the OpenSchool at existing, related, QI events
  • Make the OpenSchool modules a required piece of a course or a final piece of a grade; release some class time from theory and give more time for hands-on application during class (OpenSchool courses)
  • Attract students through events they think will be interesting and draw people in
  1. How you plan out your activities and which ones you have found to be best liked by members:
  • The best-liked activities were:
  • QI Teams
  • QI Observerships
  • ED Improvement simulation
  • IHIOpenSchool Courses
  • Comments from our year-end membership survey indicated that people really like the “simulation / game / competition” types of events, so we will plan more of those for next year
  • Plan ahead for next academic year; set objectives as to what activities you want to do; cost-effective, small scale projects (WHO package about learning errors; incident review)
  • Get local speakers; link up with things already being done within local QI departments; trained 8 facilitators (must get basic certification) that are knowledgeable about QI and the Open School; wrote an article for a local newsletter and rallied departments to get certified with the incentive that they could get in the article. The Chapter Advisory Group worked to support the Leader in bringing in Dr. David Nash for a kick-off event, which was a lunch talk. It was highly advertised and we had 200+ attendees.Currently, we are developing short quality education topics for lunch time sessions. These are linked to a similar initiative within our quality and safety department’s current initiatives. So, we are able to dovetail activities.
  • Focus on things that chapter members can actually do (e.g.: Check a Box. Save a Life and Forum Posters)  like to work towards something where they can see the final result of their work
  • Shadowing activities
  1. Whether you have done a project and how you got support for it:
  • Yes we did QI projects. (full details are in a very long email sent to the chapter leaders ListServ on May 19th)
  • In our Achieving Competency Today (ACT): Issue in Quality, Cost, Systems, and Safety course, we have interdisciplinary teams of 6-7 and each team has a trained facilitator. The teams complete projects with at least one rapid cycle test of change during the course and they identify a champion to handoff the project. 29 projects have been completed and at least half have been sustained system-wide.
  1. How did you go about interacting with local health systems?
  • We are fortunate at U of Toronto to be within walking distance of 6-7 hospitals. We asked our faculty advisors, classmates, etc, for contacts who they thought might be willing to be champions for QI teams / observerships.
  • Most of the events are in the medical school; they utilize faculty members from the Harvard hospitals, but are working on reaching out the local health systems in the future; focusing right now on getting QI into the curriculum
  • Suggests that creating a connection with the local health system will be more fruitful than just a place to go see clinical improvement in process  local health system connections are an easy way to get guest speakers and opportunities for networking- good way to recruit members
  • Set up a website for the Chapter, where local health services can advertise QI projects that they’d like students to get involved with; the students also have tons of opportunities to do elective work (QI projects) in the curriculum
  • Medication administration project, where a nurse wears a vest but it didn’t work because the nurses didn’t want to change their system. The Chapter is going away from clinical settings because the workers weren’t very open for students coming in to suggest change; moving towards more raising awareness and local events at the school
  • Itcould be helpful to ask local health systems what they would like/need in terms of a QI project instead of proposing something; this way the health system might be more receptive and appreciative.
  • Initiated conversations with other universities to join chapter. Interacted with other IHI Open School chapters, and have initiated conversation about collaboration. We have an external Web site that includes our curricular resources for the “Achieving Competency Today (ACT): Issues in Health Care Quality, Cost, Systems, and Safety” course, which is located at:
  1. What support did you get from the Open School Team that was helpful / a key factor in your Chapters success? What else can we provide to help you?
  • The most useful thing for myself, as chapter leader, was to attend the Chapter Congress at the Annual Forum. I came back with a large number of great ideas and after that point was truly the time when our chapter took off.
  • Being recognized by IHI is impressive and a huge help; Established and successful Chapters should help other Chapters; Strong faculty support is key; It would be nice if Chapters were able to submit content
  • Regional Chapter Leaders; Help us internationalize our content!; December 2010 will be able to submit user created content and courses
  • Although I graduated this year, I am continuing to be the Chapter Leader for the next year to prepare my younger medical and nursing students to become future Chapter Leaders. I would find it very helpful to learn how other Chapters created a succession plan. In addition to finding key students that are interested in patient safety, what else do they do? How can I involve our faculty in the succession plan?Similarly, what can the Open School offer to young health care leaders that have recently completed their graduate programs? As a post-student and early professional, I would like to remain active with the Open School and IHI. As an early professional interested in quality improvement and health care reform, I’m too young to apply for the mid-career fellowships or participate on a Board. How else can students like me stay connected to something we feel so passionately about on a broader level?
  • Open School resources were instrumental in communicating a shared message. Resources we used included poster, brochure, list of other chapter activities were found to be helpful for stimulating our own ideas. IHI Open School requests for chapter progress updates helped us stay on task. The Open School Chapter interest survey was also helpful—we adapted it slightly for our population and are currently surveying our members to assist us with planning this year’s activities. It would be useful to have Faculty- and Leader-specific training.
  1. What support did you get from faculty advisors that was helpful / a key factor in your Chapters success?
  • We did not receive very much support from our faculty advisors.
  • It is Essential to have faculty advisors with quality training.
  1. What support did you get from local health systems that was helpful / a key factor in your Chapters success?
  • We found numerous champions in nearby hospitals and long-term care homes / primary care facilities that were supportive of taking on students for QI projects.
  • Our system really embraces quality initiatives. We had already developed inter-departmental collaboration on the ACT course, which has reduced the silo mentality. Our system committed to the AIAMC National Initiative: To Improve Patient Care through Graduate Medical Education in 2007. We have been active members for the past 4 years.