Process Improvement

The Albright Read Institute offers an in-person, interactive team-based Process Improvement program to ensure every resident achieves a defined level of competency in the principles of process improvement.

The curriculum content is based on PHS CPIP material, with integration of Lean Principles. Upon completion of this course participants are able to:

• Examine current clinical practice and identify gaps in quality and efficiency of care.
• Understand and improve clinical processes with the application of primary data collection, analysis, and interpretation
• Develop, implement, measure and monitor plans for/tests of change
• Develop the leadership and communications skills required to assemble, function within and manage an interdisciplinary team to solve clinical process challenges.

Previous resident Improvement Process projects

• Code Status Confirmation
• MOLST Documentation
• Telemetry Utilization
• Sedation of Mechanically Ventilated Patients
• Phenobarbital for High Risk Alcohol Withdrawal
• Increasing Patient Mobilization Research Presentations
  

Faculty from the Albright Read Institute teach residents statistics and research study design to increase familiarity with these methods.

Topics include:

• Validity, bias, and types of measurement
• Data collection strategies and data types (chart selection, graphic displays, descriptive statistics and other data summary techniques)
• Hypothesis testing and variance and regression analyses
• Statistical process control
  

Residents are required to present current published research articles to their peers in a monthly journal club. ARI has provided support to residents by discussing and helping clarify the statistical methods used in the literature they present. Consulting ARI faculty provide consultative support on study design and methodology to residents who are interested in conducting research or improvement projects.

Several residents have expressed interest in writing systematic reviews on clinical topics of their interest. Residents also have the opportunity to work closely with physician mentors in various specialties to develop and analyze improvement projects. Here are just a few; some have been presented at conferences or published:

• C.Difficile Reduction project, Dr. Sara Altamimi, PGY-2, sponsored by Dr. Marc Rubin, Surgery, Dr. Barb Lambl, Infectious Disease (J. of the American Medical Informatics Assoc, 2018; J. of the Joint Commission, 2019)
• The Critical Illness Conversation, Dr. Caroline Cubbison, PGY-2, sponsored by Dr. Coleen Reid, Palliative Care, Dr. Elizabeth Stevenson, Critical Care (Journal of Critical Care Medicine, 2020)
• Procalcitonin in Antibiotic Stewardship, sponsored by Dr. Barb Lambl, Infectious Disease Penicillin Allergy testing, Dr. Samira Reyes-Dassum, PGY-2, sponsored by Dr. Barb Lambl, Dr. Ana Maria Bensaci, Infectious Disease; (Best Clinical Poster Award at Massachusetts Medical Society annual meeting , November, 2018, Clin. Infectious Disease Journal, 2019)
• Improving Hospital Care and Post - acute Care of SARS CoV2 patients, Dr. Arturo Castro-Diaz, PGY-1, sponsored by Dr. Daniela Urma, Hospital Medicine, Residency Program Director.
• Health Disparities & Covid-19 Impact on Minorities, sponsored by Dr. Patrick Lee, Chair of Medicine, Dr. Barb Lambl, Infectious Disease
• Tocilizumab, a cytokine-blocker and Severe Coronavirus disease, sponsored by Dr. Ana Maria Bensaci, Dr. Ruta Shah, Infectious Disease
• Therapeutic hypothermia in Cardiac Arrest, Dr. David Cardona PGY-2, sponsor Dr. Elizabeth Stevenson, Critical Care