A Longitudinal, Experiential Quality Improvement Curriculum Meeting ACGME Competencies for Geriatrics Fellows: Lessons Learned

Abstract

Quality improvement (QI) initiatives are critical in the care of older adults who are more vulnerable to substandard care. QI education meets aspects of core Accreditation Council of Graduate Medical Education competencies and prepares learners for the rising focus on performance measurement in health care. The authors developed, implemented, and evaluated a QI curriculum for geriatrics fellows. The evidence-based curriculum included didactics and a fellow-led QI intervention based on audit and feedback through the Practice Improvement Module in Care of the Vulnerable Elderly. QI knowledge, attitudes, and behaviors were assessed before and after the improvement project. Fellows' knowledge of QI improved (p = .0156), but behavior did not change significantly across a short-term improvement project. A structured focus group with fellows revealed themes of accountability and the importance of interprofessional teamwork in QI. QI education for geriatrics fellows can be feasible, well received, and prepare future physician leaders for patient-centered care, performance measurement, and effecting systems change.

Keywords:

• curriculum development
• geriatric fellowship
• practice change

Acknowledgments

The authors wish to thank Audrey Chun, MD, Sara Bradley, MD, Siobhan Sundel, NP, and the geriatrics fellows who participated in this study. Manuscript preparation by Dr. Callahan was supported by funds from the Department of Health and Human Services (DHHS), Health Resources and Services Administration (HRSA), Bureau of Health Professions (BHPr), under Geriatric Academic Career Award K01HP20490, “Improving Geriatrics Quality of Care Through Interdisciplinary Education in Transitions of Care.” The information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by the DHHS, HRSA, BHPR, or the U.S. government.

Notes