B.M. Wong is associate professor of medicine, Sunnybrook Health Sciences Centre, Department of Medicine, University of Toronto, and associate director, Centre for Quality Improvement and Patient Safety (C-QuIPS), Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada. K.D. Baum is professor of medicine and adjunct professor, School of Public Health, and associate chief medical officer, University of Minnesota, Minneapolis, Minnesota. L.A. Headrick is professor emerita of medicine, University of Missouri School of Medicine, Columbia, Missouri. E.S. Holmboe is senior vice president for milestones development and evaluation, Accreditation Council for Graduate Medical Education, Chicago, Illinois. F. Moss is dean, Royal Society of Medicine, and academic lead for collaboration, learning and partnerships, North West London Collaboration for Leadership in Applied Health Research and Care, London, United Kingdom. G. Ogrinc is professor of medicine, Dartmouth Institute, and senior associate dean for medical education, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire. K.G. Shojania is professor and vice chair of quality and innovation, Department of Medicine, University of Toronto and Sunnybrook Health Sciences Centre, and director, Centre for Quality Improvement and Patient Safety (C-QuIPS), Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada. E. Vaux is consultant nephrologist, Royal Berkshire National Health Service Foundation Trust, Reading, and vice president of education and training, Royal College of Physicians, London, United Kingdom. E.J. Warm is professor of medicine and program director, Department of Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio; ORCID: https://orcid.org/0000-0002-6088-2434. J.R. Frank is associate professor, Department of Emergency Medicine, University of Ottawa, and director, Specialty Education, Strategy and Standards, Office of Specialty Education, Royal College of Physicians and Surgeons of Canada, Ottawa, Ontario, Canada.
Acad Med. 2020 Jan;95(1):59-68. doi: 10.1097/ACM.0000000000002937.
Current models of quality improvement and patient safety (QIPS) education are not fully integrated with clinical care delivery, representing a major impediment toward achieving widespread QIPS competency among health professions learners and practitioners. The Royal College of Physicians and Surgeons of Canada organized a 2-day consensus conference in Niagara Falls, Ontario, Canada, called Building the Bridge to Quality, in September 2016. Its goal was to convene an international group of educational and health system leaders, educators, frontline clinicians, learners, and patients to engage in a consensus-building process and generate a list of actionable strategies that individuals and organizations can use to better integrate QIPS education with clinical care.Four strategic directions emerged: prioritize the integration of QIPS education and clinical care, build structures and implement processes to integrate QIPS education and clinical care, build capacity for QIPS education at multiple levels, and align educational and patient outcomes to improve quality and patient safety. Individuals and organizations can refer to the specific tactics associated with the 4 strategic directions to create a road map of targeted actions most relevant to their organizational starting point.To achieve widespread change, collaborative efforts and alignment of intrinsic and extrinsic motivators are needed on an international scale to shift the culture of educational and clinical environments and build bridges that connect training programs and clinical environments, align educational and health system priorities, and improve both learning and care, with the ultimate goal of achieving improved outcomes and experiences for patients, their families, and communities.
当前的质量改进和患者安全 (QIPS) 教育模式并未完全与临床护理相结合,这是实现卫生专业学习者和从业者广泛 QIPS 能力的主要障碍。加拿大皇家内科医生和外科医生学院于 2016 年 9 月在加拿大安大略省尼亚加拉瀑布组织了为期两天的共识会议,名为“建立通向质量的桥梁”。其目标是召集一群教育和卫生系统领导者、教育工作者、一线临床医生、学习者和患者,参与共识制定过程,并制定一系列可操作的策略,个人和组织可以利用这些策略将 QIPS 教育与临床护理更好地结合起来。会议提出了四个战略方向:优先考虑 QIPS 教育和临床护理的整合、建立结构并实施整合 QIPS 教育和临床护理的流程、在多个层面上建立 QIPS 教育能力,以及使教育和患者结果保持一致,以提高质量和患者安全性。个人和组织可以参考与这四个战略方向相关的具体策略,为他们的组织起点制定有针对性的行动路线图。为了实现广泛的变革,需要在国际范围内进行协作努力和内在和外在激励因素的协调,以改变教育和临床环境的文化,建立连接培训计划和临床环境的桥梁,使教育和卫生系统的优先事项保持一致,并提高学习和护理质量,最终目标是为患者、他们的家人和社区提供更好的结果和体验。