Bartman Thomas, Heiser Karen, Bethune Andrew, Crandall Wallace, McClead Richard, Davis J Terrance, Brilli Richard J
T. Bartman is associate professor, Department of Pediatrics, Division of Neonatology, Ohio State University College of Medicine, director of quality improvement for neonatal services, and associate medical director for quality, Nationwide Children's Hospital, Columbus, Ohio. K. Heiser is vice president for education and designated institutional official, Nationwide Children's Hospital, Columbus, Ohio. A. Bethune is quality improvement services education coordinator, Department of Education, Nationwide Children's Hospital, Columbus, Ohio. W. Crandall is professor, Department of Pediatrics, Ohio State University College of Medicine, Division of Gastroenterology, and medical director for quality, Nationwide Children's Hospital, Columbus, Ohio. R. McClead is emeritus professor, Department of Pediatrics, Division of Neonatology, Ohio State University College of Medicine, and associate chief medical officer, Nationwide Children's Hospital, Columbus, Ohio. J.T. Davis is emeritus professor of clinical surgery, Ohio State University College of Medicine, and assistant to the chief medical officer, Nationwide Children's Hospital, Columbus, Ohio. R.J. Brilli is professor, Department of Pediatrics, Division of Critical Care Medicine at Ohio State University College of Medicine, and chief medical officer, Nationwide Children's Hospital, Columbus, Ohio.
Acad Med. 2018 Feb;93(2):292-298. doi: 10.1097/ACM.0000000000001862.
Significant resources are expended on quality improvement (QI) training courses. The authors sought to determine whether education provided in QI course training improves self-assessed QI content competence and QI-related productivity among course graduates.
"Quality Improvement Essentials" is a four-month didactic and experiential course designed to prepare multidisciplinary professionals to participate in and lead QI efforts at Nationwide Children's Hospital (NCH). This study used a milestone-based self-assessment survey of graduates from 2012 to 2014 to gauge change in participants' self-assessed QI competency after course completion. Four competency domains were evaluated: QI knowledge; testing and implementing change using teams; data management and analysis; and spreading and sustaining science. Metrics for assessing individual QI productivity were presentation or publication of QI work outside NCH; local, regional, or national QI teaching; serving on a local, regional, or national QI committee; appointment as a QI leader; involvement in an internal or external QI collaborative; and leading a maintenance of certification Part IV project approved by NCH.
Course participation more than doubled participants' self-assessed QI competence across all four domains. Gains continued after the course, increasing with time rather than degrading. Self-assessed competency increase was significantly associated with increased QI productivity.
Self-assessed QI competence dramatically improved after participation in an educational course and continued to increase over time. Increased self-assessed QI competency correlated with increased individual QI productivity. Further studies are necessary to fully evaluate "return on investment" for this type of course.
在质量改进（QI）培训课程上投入了大量资源。作者试图确定QI课程培训中提供的教育是否能提高课程毕业生自我评估的QI内容能力和与QI相关的生产力。
“质量改进要点”是一门为期四个月的理论与实践课程，旨在让多学科专业人员做好准备，参与并领导全国儿童医院（NCH）的QI工作。本研究使用了一项基于里程碑的对2012年至2014年毕业生的自我评估调查，以衡量参与者在课程完成后自我评估的QI能力的变化。评估了四个能力领域：QI知识；使用团队测试和实施变革；数据管理与分析；以及推广和维持科学。评估个人QI生产力的指标包括在NCH以外展示或发表QI工作成果；在当地、地区或全国范围内进行QI教学；在当地、地区或全国QI委员会任职；被任命为QI领导者；参与内部或外部QI协作；以及领导一个经NCH批准的认证第四部分维护项目。
课程参与使参与者在所有四个领域的自我评估QI能力提高了一倍多。课程结束后能力仍在提升，且随时间增加而非下降。自我评估能力的提高与QI生产力的提高显著相关。
参与教育课程后，自我评估的QI能力显著提高，并随时间持续增长。自我评估的QI能力提高与个人QI生产力提高相关。有必要进行进一步研究以全面评估这类课程的“投资回报率”。
