S. Rajashekara is advanced postdoctoral fellow in health professions education evaluation and research, Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey Veterans Affairs Medical Center, and instructor of medicine, Department of Medicine, Baylor College of Medicine, Houston, Texas.
A.D. Naik is senior advisor, Veterans Affairs Quality Scholars Coordinating Center, Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey Veterans Affairs Medical Center, and associate professor, Department of Medicine, Baylor College of Medicine, Houston, Texas.
Acad Med. 2020 Aug;95(8):1201-1206. doi: 10.1097/ACM.0000000000003191.
Strong leadership is an essential factor in the success of quality improvement (QI) initiatives that generate and sustain improvements in patient outcomes. Notably, there is a rising need for frontline clinicians, who are often charged with leading QI efforts, to receive training in blended QI and leadership methods and skills. The Leading Healthcare Improvement (LHI) course is a longitudinal leadership course embedded within the Department of Veterans Affairs Quality Scholars (VAQS) program, a multisite interprofessional QI fellowship program. The LHI course was developed to provide frontline clinicians who are emerging QI leaders with the skills to lead and advance improvement efforts at their institutions. It consists of eight 60-minute online sessions and was implemented and delivered to a cohort of interprofessional fellows at 9 sites during the 2017-2018 academic year.This article describes the use of a logic model as a framework to guide the planning, implementation, and evaluation of the LHI course. The authors developed 5 logic model components: inputs, activities, outputs, short-term outcomes, and long-term outcomes. They defined the short-term outcomes using feedback from fellows and an evaluation of the fellows' abstract submissions to the VAQS Summer Institute. Submissions were reviewed to identify how fellows applied the LHI course concepts to QI projects at their respective sites. The authors also collected preliminary impact data from fellows to determine long-term outcomes.Finally, they used the logic model to inform changes to the LHI course based on the evaluation data they collected and developed plans to measure the impact of the course on learners, patients, and the health care system. The authors conclude with lessons learned to guide others who are implementing similar QI efforts.
强有力的领导力是质量改进（QI）计划成功的关键因素，这些计划可以产生并维持患者结果的改善。值得注意的是，越来越需要一线临床医生接受混合 QI 和领导力方法和技能的培训，他们通常负责领导 QI 工作。“领导医疗保健改进（LHI）”课程是退伍军人事务部质量学者（VAQS）计划内的一个纵向领导力课程，这是一个多站点的跨专业 QI 研究员计划。LHI 课程旨在为新兴的 QI 领导者的一线临床医生提供领导和推进机构内改进工作的技能。它由 8 个 60 分钟的在线课程组成，并在 2017-2018 学年在 9 个地点向跨专业研究员小组实施和提供。本文描述了使用逻辑模型作为框架来指导 LHI 课程的规划、实施和评估。作者开发了 5 个逻辑模型组件：投入、活动、产出、短期结果和长期结果。他们使用研究员的反馈和对 VAQS 暑期学院研究员摘要提交的评估来定义短期结果。提交的内容被审查，以确定研究员如何将 LHI 课程概念应用于各自站点的 QI 项目。作者还从研究员那里收集了初步影响数据，以确定长期结果。最后，他们使用逻辑模型根据收集的评估数据来告知 LHI 课程的更改，并制定计划来衡量课程对学习者、患者和医疗保健系统的影响。作者最后总结了实施类似 QI 工作的经验教训，以指导其他人。
