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PSQI Curriculum Checklist

IHI Open Course Access Directions

QI Project Template

Frequently Asked Questions

Welcome to the Maine Medical Center Patient Safety Quality Improvement (PSQI) curriculum. Maine Medical Center and MaineHealth are committed to providing a clinical learning environment that emphasizes patient safety and quality improvement as core tenets in the highest quality patient care. The Accreditation Council for Graduate Medical Education (ACGME) mandates that all programs provide education in both patient safety and quality improvement to all trainees.

This curriculum represents a minimum threshold education for all residents and fellows. Your Program Director will provide you with an outline of where in your training you are expected to complete each element of the training. Many modules will be completed during orientation and during dedicated Quality Improvement (QI) electives.

The PSQI is a tiered curriculum, where Tier 1 is required for all trainees whereas Tiers 2 and 3 are optional. Some programs may mandate some elements of Tier 2 and/or Tier 3 for their trainees. All trainees have the opportunity to complete Tiers 2 and 3. These are more in-depth training opportunities that distinguish trainees for post-graduate opportunities. Participation in an experiential QI project is a key element of this educational program.

Tier 1
Tier 2
Tier 3

Tier 1 | Required for all Residents & Fellows

Patient Safety 101 - Introduction to Patient Safety - 1 Hour, 30 Minutes | Online

Evaluation Method | Upload IHI Certificate of Completion to New Innovations

Learning Objectives

1. Summarize the scope of medical errors and preventable harm to patients in health care.

2. Describe the impact of medical errors on patients, families, and providers.

3. Explain why blaming and punishing individuals for errors rarely improves patient safety.

4. Identify four ways any provider can improve safety for patients in his or her direct care

Patient Safety 102 - From Error to Harm - 1 Hour | Online

Evaluation Method | Upload IHI Certificate of Completion to New Innovations

Learning Objectives

1. Explain the Swiss cheese model of error.

2. Define active failures and latent error and discuss their roles in causing harm.

3. List the main types of unsafe acts utilizing James Reason’s classification system.

4. Identify at least one example of how health care has reduced harm

Patient Safety 103 - Human Factors & Safety - 1 Hour | Online

Evaluation Method | Upload IHI Certificate of Completion to New Innovations

Learning Objectives

1. Explain how human factors principles apply to health care.

2. Describe how changes to processes can mitigate the effects of factors that contribute to error.

3. Define simplification, standardization, constraints, forcing functions, and redundancies.

4. Discuss the risks and benefits of using technology to improve patient safety.

Patient Safety 104 - Teamwork & Communication in a Culture of Safety - 1 Hour, 15 Minutes | Online

Evaluation Method | Upload IHI Certificate of Completion to New Innovations

Learning Objectives

1. Explain why effective teamwork is essential for promoting patient safety.

2. Define a culture of safety and discuss the features of a strong safety culture.

3. Identify four behaviors anyone can use to promote teamwork, communication, and a culture of safety.

4. Use structured communication techniques to improve communication within health care.

Patient Safety 105 - Responding to Adverse Events - 1 Hour, 45 Minutes | Online

Evaluation Method | Upload IHI Certificate of Completion to New Innovations

Learning Objectives

1. Describe four steps to take in the immediate aftermath of an adverse event.

2. Explain when you should apologize to a patient and how to apologize effectively.

3. Discuss the impact of adverse events on providers.

4. Explain how you can use RCA to address system problems in health care.

Quality Improvement 101 - Introduction to Health Care Improvement - 1 Hour, 15 Minutes | Online

Evaluation Method | Upload IHI Certificate of Completion to New Innovations

Learning Objectives

1. Describe common challenges for health care systems around the world.

2. List the six dimensions of health care, and the aims for each, outlined by the Institute of Medicine (IOM) in 2001.

3. Explain the value of improvement science in health care.

Quality Improvement 102 - How to Improve with the Model for Improvement - 1 Hour, 30 Minutes | Online

Evaluation Method | Upload IHI Certificate of Completion to New Innovations

Learning Objectives

1. List the three questions you must ask to apply the Model for Improvement.

2. Identify the key elements of an effective aim statement.

3. Identify three kinds of measures: process measures, outcome measures, and balancing measures.

4. Use change concepts and critical thinking tools to come up with good ideas for changes to test.

5. Test changes on a small scale using the Plan-Do-Study-Act (PDSA) cycle.

Quality Improvement 103 - Testing & Measuring Changes with PDSA Cycles - 1 Hour, 15 Minutes | Online

Evaluation Method | Upload IHI Certificate of Completion to New Innovations

Learning Objectives

1. Describe how to establish and track measures of improvement during the “plan” and “do” phase of PDSA.

2. Explain how to learn from data during the “study” phase of PDSA.

3. Explain how to increase the size and scope of subsequent test cycles based on what you’re learning during the “act” phase of PDSA.

Leadership 101 - Introduction to Health Care Leadership - 1 Hour, 15 Minutes | Online

Evaluation Method | Upload IHI Certificate of Completion to New Innovations

Learning Objectives

1. Describe several characteristics of leaders, who may or may not have formal positions of authority.

2. Describe different techniques for persuading different types of people.

3. Explain why achieving a workable level of unity among teammates is essential for effective team functioning.

4. List several ways to help sustain your health care leadership journey over time.

Session on Medicine Reconciliation | Video Below

Evaluation Method | Upload to New Innovations

Learning Objectives

1. Understand the importance of medication reconciliation to patient safety.

2. Competently perform medication reconciliation on all patients.

Video Recording

RCA/Safety Reporting | Video Below

Evaluation Method | Upload to New Innovations

Learning Objectives

1. Understand importance of reporting adverse events, near misses.

2. Describe the process by which events are reported.

3. Submit a mock event through RL Solutions.

Video Recording

"Quality Reporting" with Mark Parker, MD | Orientation, Recording uploaded to Canvas

Evaluation Method | Upload to New Innovations

Learning Objectives

1. Describe the key Quality metrics relevant to Maine Medical Center.

2. Understand the institutional structure for quality improvement efforts.

3. Identify key resources for patient safety concerns and reporting.

Suggested Readings

Video Recording

Exercise

Using one or more of the websites below, assess the quality of Maine Medical Center.

Do you get clarity or confusion?
What are the measures used, and are they relevant to the patient population seen in this hospital?
Does the information given reflect current performance?
Was it easy to find out about current performance?
https://www.medicare.gov/hospitalcompare/search.html
http://www.leapfroggroup.org/
http://www.getbettermaine.org/

Joint Commission Required - Clinically relevant e-modules, to be determined by Program Director, Chair, Institutional Requirements | MMC Canvas or LearningSpace

Evaluation Method | Upload Certificate of Completion to New Innovations

Learning Objectives

1. As per individual e-learn.

Review of RL Solutions Safety Reports
Your Program Director will indicate whether this experience will be offered during a didactic as a group activity or is to be done individually.
If individually, you may contact Janet Maguire, Director Risk Management, to schedule a session - maguij@mmc.org

Evaluation Method | Upload to New Innovations

Learning Objectives

1. Understand the MMC process for reviewing and acting on RL Solutions report.

2. Review real RL Solutions reports.

3. Recommend action on reviewed RL Solutions reports.

Attend a Real or Mock RCA and/or Failure Modes & Effects Analyses
Your Program Director will indicate whether the expectation in your program is to participate in a mock RCA during a programmatic didactic experience.
If you are unable to attend a programmatic mock RCA, all residents will receive intermittent invitations to attend institutional RCAs.

Evaluation Method | Upload to New Innovations

Learning Objectives

1. Describe key elements of an RCA.

2. Identify key stakeholders.

3. Understand outcomes of RCA or FMEA.

Attend Error Disclosure Training (either simulation-based or department organized) | Scheduled by Department

Evaluation Method | Upload to New Innovations

Learning Objectives

1. Articulate the importance of medical error disclosure.

2. Disclose a medical error with honesty, compassion and respect for all team members in a safe, educational setting.

3. Articulate the relevance of medical disclosure to the institutional patient safety culture.

Joint Commission Required - Vascular Access/PICC
Simulation Training Center (Only required for certain programs. Please check with your Program Director to see if your program requires this course.)

Evaluation Method | Upload Certificate of Completion to New Innovations

Learning Objectives

1. Describe the importance of bundled approach to managing vascular access.

2. Understand the protocol.

3. Know resources for needed assistance.

4. Describe the importance of no/low infection rate for patient safety and institutional priorities.

Department specific QI session with Program Director, Chair, Delegate
As determined by Program Director

Evaluation Method | Upload to New Innovations

Learning Objectives

1. Articulate departmental or service line quality improvement priorities.

2. Understand how resident/fellow contributes to success of departmental project.

3. Describe metrics for success.

Quality Improvement Project Participation
Participate in an interprofessional QI project during residency training EITHER resident initiated OR resident co-lead on unit, departmental, educational, residency project
Resident or Program Director Initiated

Evaluation Method | Completion & Submission of MMC Quality Improvement Template in New Innovations

Learning Objectives

1. Identify ‘gap’ in quality.

2. Define project goals.

3. Develop project plan and intervention.

4. Evaluate project and outcomes.

5. Articulate next steps and lessons learned.

6. Coordinate dissemination of findings (MMC QI template, local or national presentation).

Tier 2 | Optional for all Residents & Fellows

Lean Six Sigma White Belt - Training Course | Online or In-Person

Evaluation Method | Upload Certificate of Completion to New Innovations

Learning Objectives

1. Acquire a basic understanding of Six Sigma and Lean.

2. Obtain knowledge about the DMAIC process (Six Sigma structure) and their roles.

3. Understand specific DMAIC processes including how to define, measure, analyze, improve, and control.

4. Reduce resources and waste, while augmenting satisfaction among customers.

Course Overview

In this course you’ll learn about the basics of Lean Six Sigma, its improvement methodologies and primary roles. You’ll practice applying its tools and understand the commitment necessary to successfully implement Lean Six Sigma.

Training is offered both online and in-person, both are free:

The online version uses a multi-media format that includes audio by Lean Six Sigma experts, examples of successful performance improvement, interactive simulations and quizzes, and the most current and robust tools and techniques available. The course is “self-paced” and can be accessed at any time – and – anywhere, which provides the most flexibility in completing the course. On average, students complete the Lean Six Sigma White Belt training course in 6 hours (average completion time, actual time may vary).
The in-person version has more hands-on activities and is one full day of training.

Contact Katie Mahannah at Katie.Mahannah@mainehealth.org or 207-400-6607 to enroll. Click here for an informational flyer.

Attend Infection Prevention meeting | Resident-Initiated

Evaluation Method | Upload to New Innovations

Learning Objectives

1. Describe key stakeholders in institutional level committees.

2. Understand how committee outcomes effect institutional quality improvement.

3. Define metrics of success for this committee.

Attend Diagnostic Error Workgroup meeting | Resident-Initiated

Evaluation Method | Upload to New Innovations

Learning Objectives

1. Describe key stakeholders in institutional level committees.

2. Understand how committee outcomes effect institutional quality improvement.

3. Define metrics of success for this committee.

Attend Patient Safety Committee meeting | Resident-Initiated

Evaluation Method | Upload to New Innovations

Learning Objectives

1. Describe key stakeholders in institutional level committees.

2. Understand how committee outcomes effect institutional quality improvement.

3. Define metrics of success for this committee.

Tier 3 | Optional for all Residents & Fellows

Lean Six Sigma Green Belt - Training Course | Online or In-Person
100 hours of online education plus a mentored project

Evaluation Method | Upload Certificate of Completion to New Innovations

Learning Objectives

1. Understand Lean Six Sigma and the DMAIC methodology.

2. Learn and apply skills in project management, process improvement, lean, change management, and basic statistical analysis.

3. Properly scope, define and lead Lean Six Sigma projects.

4. Present projects to peers, managers and senior leadership.

5. Apply basic statistical analysis to determine the relationship between key inputs and process outputs.

6. Implement controls to sustain gains.

7. Effectively manage team dynamics.

Online Course Overview

The Certification course has been designed to teach Lean Six Sigma fundamentals and its application. Students are trained and tested on their understanding and ability to apply the tools and techniques in all elements of the Lean Six Sigma DMAIC methodology. As part of the DMAIC methodology, students are taught how to integrate Lean Six Sigma into an overall approach to process improvement and project management.

Training is conducted online and uses a multi-media format that includes audio by Lean Six Sigma experts, examples of successful performance improvement, interactive simulations and quizzes, and the most current and robust tools and techniques available. The course is “self-paced” and can be accessed at any time – and – anywhere, which provides the most flexibility in completing the course. On average, students complete the course in 105 hours (average completion time, actual time may vary).

Contact Shelley Chorney at chorns@mainehealth.org or 207-661-7613 for information on cost and enrollment.

In-Person Course Overview

This is 4 full days of training, three weeks apart. Participants will be introduced into lean thinking, techniques, tools and an overview of six sigma. The training has the right mix of theory and hands on group exercises. With the help of black belt coach, participants will work on their own projects to gain the full benefit of the training. The experience of working on a real project is our evidence-based practice to make sure that theory is put into practice. By the end of the training each participant (or group of participants) will have their planning phase of their own lean improvement project completed. 4-6 weeks later on, participants will be called to present on the progress of their projects and receive feedback from fellow green belts, black belt coaches and Improvement Specialists. The participants will be invited again to present on their complete project storyboard in a gallery walk, where senior leaders will be invited.

The first day will cover Lean Thinking and the Plan-Do-Check-Act model. The day dedicates enough time to understand the features of different management systems and the mindset of those systems. It also concludes with what makes our OPEX Management System the best in class.

The second day will focus on the tools that help in problem identification and problem analysis. Root cause analysis tools are the way to go to make sure that you are treating the real issues and not the symptoms of the problem. The second part will teach how to come up with solutions to those problems? How to prioritize them? How to pilot improvement?

The third day covers process and value stream mappings. The famous tool that helps us sees the current state of our work as a flow. This puts us in a better position to understand where we are, and where are the bottlenecks in our workflows? The same day participants cover 15 different recipes on how to improve current states and come up with a better future state value stream.

The fourth day is about how to run a kaizen/or a lean improvement project from A to Z. This day will teach everything we need to run a successful improvement event, from developing the charter until you hand off the project to the process owner.

Contact Shelley Chorney at chorns@mainehealth.org or 207-661-7613 for information on cost and enrollment.

--OR--

MMC Certificate in Health Care Improvement | Online

Evaluation Method | Submit an abstract to a quality-safety meeting, e.g., IHI National Forum or IHI/NPSF Patient Safety Congress (upload to New Innovations)

Course Overview

The Certificate in Health Care Improvement is designed to train inter-professional clinical teams in practical skills for health care improvement, grounded in the science of health care delivery. These teams will leverage partnerships outside traditional boundaries, foster inter-professional teamwork, and lead the change to improve health care delivery and population health in their community.

The Certificate Program consists of a self-study period, three onsite meetings, four content modules and a concurrent improvement project. The Program is supported by the Department of Medical Education and Center for Performance Improvement at Maine Medical Center/ MaineHealth. Program Leadership is provided by Drs. Kathleen Fairfield and Peter Bates. The Program is conducted in close collaboration with the Tufts University School of Medicine (TUSM) - Maine Track Longitudinal Integrated Clerkship (LIC).

The learning model was developed by The Dartmouth Institute for their MPH program, and is a highly effective method of blended learning that combines high quality online materials (approximately 2 hours of content weekly) with once-weekly synchronous, one-hour sessions where participants and faculty interact. Additionally, the teams and faculty meet in person at the beginning, mid-way point and at the conclusion of the program to connect with the teams and provide input and coaching on projects. A weekly Discussion Board provides additional faculty-participant interaction.

Throughout the course, each team will engage in an improvement project, selected based on their own assessment of greatest need and interest locally. The teams receive support from improvement coaches through the MaineHealth Center for Performance Improvement (CPI).

Submit an abstract to a quality-safety meeting, e.g., IHI National Forum or IHI/NPSF Patient Safety Congress or a medical professional society national meeting—quality/safety track

Contact Mark Parker at parkem@mmc.org or 662-2018 for information on registering.

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