National Initiative III

NI III built on the strengths of NI I and II, but moved beyond direct support of local quality improvement teams to the development of teaching leadership and changing organizational culture to support quality improvement initiatives. Graduate medical education and continuing medical education were emphasized as platforms for improving patient care.

The focus of NI III was faculty/leadership development. We recognized that program directors and other teaching faculty were not currently equipped to successfully meet the ACGME’s new Common Program Requirements (CPR) effective July 1, 2011, and the AIAMC National Initiative would be a rich resource in meeting these needs. We also recognize that part of our responsibility as medical educators is to train the next generation of practicing physicians; thus, residents must be considered as junior faculty and included in this effort.

NI III directly addressed the Common Program Requirements’ directives in Professionalism, Personal Responsibility and Patient Safety by educating program directors, faculty members and residents in a train-the-trainer approach. Further, NI III assisted our members in meeting the requirement of residents actively participating in interdisciplinary clinical quality improvement and patient safety programs. The structure and content of NI III also met the CPR’s directives with regard to Teamwork by providing training in effective communication as part of inter-professional teams.

Structurally, NI III engaged faculty members, program directors, residents, continuing education specialists and quality improvement leaders in a cohort model of learning. Building and sustaining these high performance leadership teams included training in the following areas:

1. Team Leadership and Team Skills (leadership development)
2. Purpose and Process Improvement (teaching content)
3. Team Relationships and Communication (teaching, mentoring)
4. Measures, Outcomes and Sustainability & Spread of Change (show results)

Four on-site meetings of participants were held. We learned in NI I and II that monthly check-ins were vital to keeping the local teams on track, so we continued with monthly teleconferences for this purpose. In NI III, we added educational webinars in an effort to increase the quality of this collaborative experience.

AIAMC member institutions participating in the National Initiative found the experience a most valuable one and were rewarded with many beneficial outcomes, including:

1. Alignment of GME and CME with hospital leadership and boards to improve quality of patient care;
2. Recognition of the central role of GME and CME in quality improvement and patient safety;
3. Acknowledgement of the potential for faculty and residents to be change agents for quality improvement and patient safety;
4. Development of a national network for improvement and sharing of best practices with IAMCs across the United States;
5. Opportunity to author one or more manuscripts at the conclusion of the series.

And, of course, the most important outcome of the National Initiative was its positive and measurable impact upon improving patient care and improving medical education.