Building Psychiatric Quality Programs and Defining Quality Leadership Roles at Four Academic Medical Centers
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Building Psychiatric Quality Programs and Defining Quality Leadership Roles at Four Academic Medical Centers Luming Li 1
&
Whitney E. Black 2 & Erick H. Cheung 3 & Weston S. Fisher 4 & Kenneth B. Wells 3
Received: 2 July 2020 / Accepted: 8 September 2020 # Academic Psychiatry 2020
Quality of care has become an important concept in healthcare, following the Institute of Medicine report “To Err is Human,” which suggested that there were as many as 98,000 medical errors per year in 1999 [1]. According to the US Health and Human Services Agency, Quality improvement (QI) “consists of systematic and continuous actions that lead to measurable improvement in health care services and the health status of targeted patient groups” [2]. Academic departments have a multifaceted mission to educate future healthcare leaders, provide high-quality care and value for patients, and advance research and scholarship innovation [3]. Many academic medical centers, under which clinical departments function, are tasked with addressing growing demands of value (quality and safety and experience divided by cost), as well as with supporting effective QI activities [4]. However, several barriers have been described in implementing quality programs within academic departments, including lack of departmental support, limited engagement by faculty and trainees, and limited expertise in QI [4]. Prior publications have described faculty development in QI and patient safety expertise and have documented the successful development of quality programs in other specialties such as internal medicine [5, 6]. In psychiatry, QI projects are well described in the literature, including innovative projects to reduce antipsychotic
* Luming Li [email protected] 1
Yale University School of Medicine, New Haven, CT, USA
2
Oregon Health & Science University School of Medicine, Portland, OR, USA
3
University of California Los Angeles School of Medicine, Los Angeles, CA, USA
4
University of California San Francisco School of Medicine, San Francisco, CA, USA
polypharmacy, integrate behavioral health and primary care, implement interdisciplinary care rounding, and structure handoffs to improve communication [7–9]. The development of QI programs using a maturity matrix in psychiatry has also been previously described [10]. Within clinical training, QI and patient safety are explicitly described in the practicebased learning and improvement and system-based based practice core competencies and are now requirements as part of the Accreditation Council on Graduate Medical Education Milestone assessments [11]. Despite the need for QI programs within academic settings, descriptions of psychiatric QI programs in academic medical centers are not well characterized in the literature. In this column, the authors aim to describe four academic psychiatry quality programs; highlight the roles, responsibilities, and critical skills of QI leaders; and share project examples.
The Four Programs The four psychiatric quality programs described in this colu
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