ProjectConnect: A Quality Improvement Project for … Quality Improvement Projects

The Tulane University IHI Open School Chapter, the first one in Louisiana, was founded in December 2010. In just one year, we've seen our membership grow to more than 70 members that have initiated multiple quality improvement projects at Tulane Medical Center.

Organizing all of those projects, ironically, turned into a quality improvement project itself.

Let’s first step back a bit. We started holding monthly meetings in early 2011, open to medical students and faculty, to discuss quality improvement related topics in health care, many of which were based on modules available on the IHI Open School website. After speaking with many students and faculty who attended those initial gatherings, we began to understand that our medical community was full of enthusiastic faculty and students who wanted to get involved with quality improvement at Tulane. However, we didn't really know how to get started connecting everyone with this shared interest and enthusiasm. We made solving this problem our main goal.

We decided that the most effective quality improvement project would be to connect the like-minded individuals in our medical community and enable them to actually do quality improvement. This is how we came up with ProjectConnect, an online quality improvement project repository and social network. We designed ProjectConnect with three goals in mind:

1. Provide a secure online platform to create, share, and manage quality improvement (QI) projects. 2. Facilitate collaboration and mentorship between Tulane faculty and medical students on QI projects. 3. Promote QI and patient safety awareness within the Tulane community.

After two months of internal meetings and guidance from our faculty advisor, Dr. Frank Rosinia, we submitted a formal business proposal to our dean's office, made a formal presentation, and secured funding for the development of ProjectConnect. We spent the next five months developing and testing the application. For example, we made sure students and faculty could log-in with their existing emails and that project data was visible to everyone after it was entered. Meanwhile, we continued holding Chapter meetings every six to eight weeks to build our chapter membership.

In August 2011, we held a faculty breakfast to unveil ProjectConnect. We asked the faculty – from Tulane Hospital, the medical school and the school of public health – to bring their laptops to breakfast so we could teach them how to log-in and enter projects into the system. (Gaining faculty support was crucial to our effort.)

Once we had some QI projects loaded, we scheduled a meeting to introduce ProjectConnect to our medical student community. The student response has been tremendous, and today there are more than 20 QI projects in the system in various stages of completion. A few examples of the work that’s going on:

• Improving patient handoff efficiency
• Reintroducing a surgical safety checklist in the ORs at Tulane
• Decreasing CLABSI rates
• Developing an effective method to train first- and second-year medical students in clinical documentation

Our Chapter continues to grow and the incoming student leadership has big ideas for developing a QI elective based on IHI Open School modules, with the goal of incorporating it into our medical school curriculum in 2012.

- Clinton Piper, medical student, Tulane University

Chapter Corner: Three Questions to Consider When Planning Quality Improvement Projects

Quality improvement projects benefit both students and organizations in a number of ways. Students have the opportunity to network and develop their improvement skills. Organizations, meanwhile, have the opportunity to meet enthusiastic students dedicated to improving healthcare, develop fresh ideas with student contributions, and guide and mentor the next generation of health professionals.

We just had our fall information session last week, and students have begun sending in their project applications. This is the first year the Atlanta chapter of the IHI Open School has embarked on establishing quality improvement opportunities for students.

Our goal is for students to gain real-world experience by participating in improvement projects, whether it is a snapshot or the various phases of a project. In addition to skills in quality improvement, some of these projects will also allow students to develop skills in patient safety, teamwork, leadership and patient-centered care.

Finding projects
Our group focused heavily on recruitment to gauge student project interest while simultaneously searching for project opportunities at various organizations. We wanted to ensure that there would be enough student interest to participate, but also wanted to ensure that project opportunities existed for student volunteers. I used contacts from informational interviews, previous internships, and professors to ask if their organizations might be interested in having students volunteer their time to quality improvement projects. If these contacts expressed interest, we then discussed the potential projects over a phone call.

Here are a few of the questions we kept in mind during the project planning process:

1. How can we develop and maintain good relationships with participating organizations?
If we maintain good relationships with these organizations, we might find additional project opportunities in the future within and outside of the organization. To maintain these relationships, we plan on touching base with project supervisors every so often throughout the project. And since this is our first year, we have limited the number of IHI Open School projects so we can focus on successful completion of these few projects.

2. What if we get a smaller applicant pool than we expect?
We wanted enough student interest so that each project would be able to find a number of students from various disciplines that would be a good fit for the organization. We emailed faculty/department advisors and our student government association to forward on our IHI Open School information to students. And since medical students are difficult to recruit due to their incredibly busy schedules, we contacted dual degree MD/MPH students that are in their MPH year, where the schedule is more flexible. Our final applicant pool is still yet to be seen.

3. How can we encourage students to share experience and knowledge with other students? While we want students to develop various skills, we also want them to share their project work and knowledge with other fellow students. We hope that this will create a culture of teaching others, developing leaders, and building relationships. We'll be setting up Open School meetings for students to share what they've learned.

It will be interesting to see how these projects progress over the course of the year. If anyone has any comments or suggestions, we would love to hear them!

- Becky Ng, Public Health student, Emory University

University of Minnesota Strives to Improve QI in Public Health

Quality improvement (QI) in public health is still not well defined, as there is often confusion about how the tools, techniques, and methodologies fit together.

Just a few of the challenges:

• Specific programs, such as emergency preparedness, are more likely to utilize QI methods than others.
  
• The IHI QI models are transferrable to the public health sector, but the governmental nature of public health departments are not typically found in other organizations, and can be an added challenge.
  
• The National Board of Public Health Examiners, the Public Health Accreditation Board, and the Council on Education for Public Health have voiced concerns about the need to provide more educational opportunities in performance improvement to working public health professionals.

Despite these obstacles, QI strategies will play a vital role in improving outcomes, especially as demands on the U.S. public health system continue to increase. In an effort to address these concerns, the University of Minnesota's School of Public Health is launching its certificate program for public health performance improvement.

The program, which is launching this fall, is designed to prepare public health professionals for successful leadership and implementation of quality improvement initiatives within their respective organizations. To become certified, a student must earn a minimum of 12 credits during five terms, which can be taken in person or online. Students will have the opportunity to apply their knowledge by leading an improvement team within their organization.

It's my hope that other universities across the country will also take steps to create quality and performance improvement certifications and concentrations to give students and working professionals the skills to implement successful improvement initiatives.
For more information on Minnesota's certificate, view this PDF: http://www.apha.org/NR/rdonlyres/47FDA17C-1B25-43D1-8E40-2CE17B0E8326/0/PerformImprovePubHInformsheet.pdf

Or visit the official website: http://www.sph.umn.edu/programs/certificate/piph/index.asp

- Becky Ng, Public Health student, Emory University