Quality Improvement and Patient Safety
The UK Department of Otolaryngology provides the opportunity for residents to be involved in quality improvement and patient safety (QIPS) activities.
Monthly QIPS Conference
Morbidity and mortality cases are reviewed, and the faculty mentor chooses two-to-three cases for in-depth review and root-cause-analysis. Residents develop short didactic presentations along with a fish-bone diagram, with goals of improving patient care, performing root-causes analysis, providing a literature review, teaching members of the department, and serving as board-review material.
Quality Improvement Projects
The UK Department of Otolaryngology-HNS QI officer implements QI projects based on reviewed QIPS cases. As an example, residents have been actively involved in electronic medical record order set improvement, pediatric tracheostomy care and teaching improvement, etc.
The department chair, program director, associate program director, departmental QI officer, and all residents attend SWARM training. At the University of Kentucky, "SWARM" is the term used for root-cause analysis. During these sessions, UK leadership, faculty, and residents are involved in a mock SWARM based on a real event. The facilitator and attendees can stop the SWARM in real-time to review statements, ask questions, or gain a better understanding of the process. Review of data suggests that attendees of these events feel significantly more confident in their knowledge of root-cause analysis after attending simply one simulation.
While most institutions participate in systems-level root-cause analysis, UK is part of the Patient Safety Leaders collaborative with the ACGME and several other academic institutions nationally. In light of this, our interns are taught SWARM methodology at the unit-level. In these meetings, the intern(s) leads an analysis of an event, develops a fish-bone diagram of the involved factors, and then recommends, with guidance, QIPS protocols that can be implemented to improve unit-level and/or patient safety factors.