Published: Jan. 13, 2012
Updated: Jan. 13, 2012
In early 2010, house staff with special interests in patient safety and quality improvement coalesced to form the Duke GME Patient Safety and Quality Council (PSQC).
With executive-level support and health system resources, residents and fellows from across Duke University Hospital formed interdepartmental partnerships and began working together to address broad patient safety and quality issues.
The PSQC's early work has focused in three primary areas -- handoffs, education, and supervision -- with the Handoffs Initiative being the most productive to date.
Work on the PSQC's Handoffs Initiative began in August 2010 to prepare Duke's GME community for major changes around transitions in care in GME regulations (known as the ACGME Common Program Requirements).
Members spent months reviewing the relevant literature to identify best practices around handoff structure, education, and evaluation, and developed a comprehensive plan to reform transitions in care among Duke's house staff.
Its first efforts were focused on defining a flexible method of standardizing handoffs among varying clinical specialties.
In January 2011, PSQC brought its new standardized guidelines for handoff core content to both ICGME and ECMS for review and met with broad approval.
To help implement the new core-content guidelines, the group developed a new teaching session for institution orientation and worked with individual programs to implement program-level modifications.
Working with GME's IT specialists, the group then created an electronic evaluation template within GME’s existing MedHub system. The tool incorporates the new hospital-wide core content and will serve as a mechanism for both programs to evaluate trainees and the institution to monitor program compliance with the new handoffs guidelines.
PSQC members have presented the work of the Handoffs Initiative at multiple national meetings and written a manuscript that has been accepted for publication in a major national journal, with the hope that the experience at Duke can serve as a model for other institutions to engage house staff in safety and quality initiatives.