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Put Residents at the Center of Patient Safety With Housestaff Quality Councils

Julie McCoy, May 28, 2010

Rolling out new policies and procedures is a challenge for hospital leaders. Effective communication is critical to ensuring healthcare staff comply with new patient care protocols. House staff are an important audience to reach because they're typically providing the bulk of patient care in many hospitals. Without their buy in and support, many initiatives fall short.

New York-Presbyterian Hospital's Housestaff Quality Council (HQC) provides hospitals with a model for engaging residents in patient safety and quality initiatives and policymaking.

The HQC is a win-win
The HQC facilitates two-way communication between residents and the rest of the hospital—administrators, hospital and patient safety, nursing, etc.—regarding quality and patient safety issues and initiatives, says Peter Fleischut, MD, anesthesiology resident at New York-Presbyterian and cocreator of the HQC.

"The mission of the HQC is to engage house staff in policy and decision-making processes to further improve quality and patient safety within the institution," Fleischut says.

The council is run by residents, but other members include:

  • Resident representatives from each department
  • Faculty advisor
  • Liaison from the office of quality and patient safety
  • Office of the vice president representative
  • Representatives from infection control, nursing, epidemiology, and pharmacy

With an HQC, institutions can more easily:

Identify opportunities to improve frontline patient care. Although hospital administrators can identify quality initiatives derived from data, such as hand hygiene compliance, they often do not have insight into what's happening on the front lines of patient care.

Residents have this knowledge and can identify system issues that can be improved to prevent errors, says Adam S. Evans, MD, MBA, anesthesiology resident at New York-Presbyterian and cocreator of the HQC.

However, residents often do not have a venue for making their observations known and they are not invited to help develop solutions. During HQC meetings, residents have the administration's ear, and they can partner with them and other hospital departments to develop solutions.

Increase compliance with new policies. All too often, decision-makers develop patient care policies or processes without resident input or an effective way to spread the word. Ultimately, they end up with low compliance rates.

"House staff need to be at the table and they need to be involved in the decision-making process," says Gregory E. Kerr, MD, MBA, associate professor in the Department of Anesthesiology and faculty advisor for the HQC at New York-Presbyterian.

By engaging residents and asking them for solutions, the hospital gets their perspective on important patient safety issues, and creates buy-in with trainees, Kerr says.

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