Experiences of interprofessional implementation of a healthcare matrix.

The Taiwan Joint Commission on Hospital Accreditation endorsed the Institute of Medicine (IOM) dimensions of health care quality as safe, timely, effective, efficient, equitable, and patient-centered. The Taiwan Association of Medical Education has also adopted the Accreditation Council for Graduate Medical Education (ACGME) outcome project and core competencies for Taiwan physicians in training. These schemes focus on patient care, medical knowledge and skills, interpersonal and communication skills, professionalism, system-based practice and practice-based learning and improvement. Bingham (2004) described a Healthcare Matrix that links to the ACGME Core Competencies and the IOM Dimensions of Quality as a tool to improve health care. The matrix provides a blueprint to help residents learn the core competencies in patient care, and to help the faculty to link mastery of the competencies with improvements in quality of care. However, the "six-by-six" framework was too complicated to fill in. Furthermore, the translation of the IOM aims and ACGME core competencies into the Chinese language seemed incoherent and difficult to remember. We simplified the matrix by merging some columns of the original Healthcare Matrix, and reduced the 6 x 6 form into a 4 x 5 framework. The matrix was applied in case conferences, mortality and morbidity conferences, combined meetings and nursing quality assurance meetings in different departments. This format organizes the presentation and discussion, highlighting strengths or deficiencies in key aspects of patient care. With interprofessional collaboration, the matrix has been used in the departments of Plastic Surgery, and Nursing and Performance Management in our hospital. The achievements are encouraging. The Taiwan Edition Healthcare Matrix is worthy of consideration, having been used in a Mandarin-speaking region of Asia.