Date: July 23, 2010
In one Johns Hopkins residency program, physicians get a break from patient care duties so they can tackle quality improvement projects.
An 80-hour workweek gives residents valuable insight to the hazards facing their patients. But it also leaves them scarce time to play a role in patient safety and quality improvement teams.
At The Johns Hopkins Hospital, one department is trying to change all that. Last summer, Anesthesiology and Critical Care Medicine introduced a revamped training program that sets aside two days a month when residents have no patient care duties. While some of that time is spent in board exam preparation, a journal club and simulation exercises, a significant portion of those two days is devoted to taking part in quality and safety efforts.
Now, the 71 residents are working on 11 projects. Among other efforts, they’re studying ways to improve communication among health care workers, increase recycling and prevent postsurgical nausea and vomiting.
“We typically come to work and focus on the patients we have that day,” says resident Jim Rothschild. “And that’s good to a point, but this is forcing us to take a step back and say, How can we improve how health care is delivered?”
Anesthesiologist Sean Berenholtz, who co-directs this component of the residency program, says house staff are constantly working to steer patients clear of harm. Many would rather tackle the source of the problems. But he says they often don’t have the skills, the hospital connections or the infrastructure to fix safety hazards.
The training program helps them to clear those hurdles. The residents get instruction in how to design safer, less wasteful systems. They learn how to find the best medical evidence and turn it into practice, and how to improve teamwork and communication, among other lessons.
Led by faculty mentors, groups of residents then apply what they’ve learned as they work across departments and the hospital to seek solutions.