Adapting SQUIRE 2.0 to Create a Quality Improvement Evidence-Based Medicine Critical Appraisal Tool (QI-EBM-CAT) for Graduate Medical Education Trainees.

Background: Evidence-based medicine (EBM) has long been taught to physician trainees for critical appraisal of research manuscripts. There is no parallel or similar framework to guide trainees in the appraisal of quality improvement (QI) literature.

Objective: To adapt existing guidelines of QI manuscript reporting into an educational QI-EBM appraisal tool to help residents distinguish research and QI manuscripts, assess QI designs and methodologies, and evaluate QI manuscripts' strengths and weaknesses.

Sustainability of a Multifaceted Intervention to Improve Surrogate Decision Maker Documentation for Hospitalized Adults.

Documenting surrogate decision makers (SDMs) is an important step in advance care planning (ACP) for hospitalized adults. The authors performed a quality improvement study of clinical and electronic health record (EHR) workflows aiming to increase SDM documentation for hospitalized adults. The intervention included an ACP education module, audit and feedback, as well as workflow and EHR adaptations.

Simulating for Quality: A Centralized Quality Improvement and Patient Safety Simulation Curriculum for Residents and Fellows.

Problem: Requirements for experiential education in quality improvement and patient safety (QI/PS) in graduate medical education (GME) have recently expanded. Major challenges to meeting these requirements include a lack of faculty with the needed expertise, paucity of standardized curricular models allowing for skill demonstration, and inconsistent access to data for iterative improvement.

Approach: In October 2017, the authors began development of a centralized QI/PS flipped-classroom simulation-based medical education (SBME) curriculum for GME trainees across multiple disciplines at Oregon Health & Science University (OHSU).

Prevalence and Characteristics of House Staff Quality and Safety Councils Within Clinical Learning Environments: Results of a National Survey.

House Staff Quality and Safety Councils (HQSCs) are relatively new multispecialty groups led by residents and fellows that focus on quality and safety activities at their training site. The authors sought to estimate the prevalence of HQSCs, describe their common characteristics and determine any perceived impacts. A national survey was conducted with Designated Institutional Officers (DIO) of graduate medical education programs in 2019.

The Mystery Dinner RCA: Using Gamification and Simulation to Teach Root Cause Analysis.

Introduction: Root cause analysis (RCA) is a widely utilized tool for investigating systems issues that lead to patient safety events and near misses, yet only 38% of learners participate in an interdisciplinary patient safety investigation during training. Common barriers to RCA education and participation include faculty time and materials, trainee time constraints, and learner engagement.

Methods: We developed a simulated RCA workshop to be taught to a mix of medical and surgical specialties from over 11 GME programs and to third-year medical students.

Faculty Development in Improvement Science: Building Capacity and Expanding Curricula Across an Academic Health Center.

Background: The ability of health professions faculty to design, teach, evaluate, and improve relevant curricula is vital for teaching improvement science (IS) skills to trainees.

Objective: We launched a Foundational Improvement Science Curriculum (FISC) to build faculty competence in IS teaching and scholarship, and to develop, expand, and standardize IS curricula across one institution.

Methods: FISC consisted of 9 full or half-day sessions over 10 months in 2015-2016 and 2016-2017 academic years.

A Resident-Led Initiative to Increase Documentation of Surrogate Decision Makers for Hospitalized Patients.

Background: Identification of surrogate decision makers (SDMs) is an important part of advance care planning for hospitalized patients. Despite its importance, the best methods for engaging residents to sustainably improve SDM documentation have not been identified.

Objective: We implemented a hospital-wide quality improvement initiative to increase identification and documentation of SDMs in the electronic health record (EHR) for hospitalized patients, utilizing a Housestaff Quality and Safety Council (HQSC).

Epidural abscess caused by Mycobacterium abscessus.

Background: Mycobacterium abscessus is a member of the Rapidly Growing Mycobacterium (RGM). The incidence of Mycobacterium abscessus infections has steadily been increasing over the last decade. We report the case of an epidural abscess caused by Mycobacterium abscessus.