Beyond the Electronic Health Record: Expanding the Reach of Quality Improvement Education

Track: Research

Session Number: 2037
Date: Wed, Sep 27th, 2017
Time: 12:15 PM - 12:30 PM

Description:

Robust quality improvement (QI) initiatives in health care settings often employ repeated cycles of the plan-do-study-act process involving patient chart data review and targeted feedback to benchmark current practice performance and measure improvement over time. Implementation of QI projects, particularly in the context of the continuing education enterprise, requires the confluence of several factors: the existence of validated performance metrics that are easily abstracted, engagement of a health system with access to patient records, active leadership by a local site champion and buy-in by clinical teams, and viable financial support that is not constrained by a 12-month lifecycle of more traditional CME/CE courses. However, successful alignment of these factors can be challenging for a multitude of reasons, frustrating education providers who strive to facilitate meaningful and tangible change in the quality of healthcare provided in the United States.

The electronic health record (EHR) is a rich source of information that can be used to drive QI efforts in clinical settings, though it is not an absolute requirement for a well-designed initiative intended to facilitate process improvements and behavior change. Indeed, there are many aspects of clinical care that are not easily captured by the EHR – such as those related to communication with patients and colleagues and managing treatment adherence – which can be explored via qualitative methods. Furthermore, compared with data abstracted from the EHR, this type of research approach is uniquely positioned to critically assess clinic workflows and care team dynamics through reflection on current practice and guided discussion about barriers to optimal care. Such insights can, in turn, be used as the basis for the development of a focused improvement plan specifically tailored to the needs and resources of a particular practice. While progress toward achieving the identified improvements is not quantifiable through chart abstraction in this model, structured follow-up to determine the downstream effects of changes in attitudes, behaviors, and processes on care quality can serve as a proxy measure for softer skills that may be just as important to ensuring good patient outcomes as optimizing treatment selection.

This session will engage participants in a conversation about strengths, limitations, and the potential application of quality-focused initiatives that do not involve the abstraction of patient data from the EHR to address key clinical practice gaps. The ultimate goal of this discussion is to outline a framework for qualitative practice assessment interventions that can be incorporated into participants’ own curricula to support industry-wide efforts to improve care quality across a variety of specialties and healthcare settings.
Session Type: Skill Building Workshop

Learning Objective 1: Identify elements of clinical care that are well suited for qualitative, quality-based interventions
Learning Objective 2: Describe a framework for qualitative interventions to facilitate clinician reflection on current practice and support process improvement over time
Learning Objective 3: Design quality-based initiatives that address aspects of clinical care that are not tracked through data captured in the electronic health record
Session Type: Skill Building Workshop

Learning Objective 1: Identify elements of clinical care that are well suited for qualitative, quality-based interventions
Learning Objective 2: Describe a framework for qualitative interventions to facilitate clinician reflection on current practice and support process improvement over time
Learning Objective 3: Design quality-based initiatives that address aspects of clinical care that are not tracked through data captured in the electronic health record