Regardless of where we practice medicine, it is up to us as individual physicians to ensure the highest quality of care that we can deliver to our patients. At each location, the demography and cultural composition of our patients have revealed different approaches to language barriers, self-understanding of disease, and even the perception of pain.
As a physician, I wrote a recent essay that describes the obstacles I believe most significantly impede the adoption of standards of healthcare delivery in these diverse settings.
I have obtained Six Sigma and LEAN certification and patient safety curricula, and published work on outcomes-based research studies and clinical trials on informatics tools in peer-reviewed journals.
Perioperative Workflow Optimization with Lean management system
Continuous Practice Improvement with Six Sigma DMAIC
#tbt the 2017 Accreditation Council of Graduate Medical Education (ACGME) conference in Orlando, FL. I was honored to receive the David C. Leach Award for our resident-led quality improvement project at Harborview Medical Center in Seattle, WA.
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A multidisciplinary team of residents, nurses, surgeons, and administrators convened to improve the postoperative handover process. Rather than simply creating and requiring the use of a checklist, we gathered input from housestaff, sought feedback critical to implementation, and studied the compliance and use of a structured handover protocol. The project took three months of brainstorming, a year to carry out the project, and collect data, and now more than three years to analyze, write, and vet it for peer-reviewed journal submission, amidst our personal and career objectives.
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Quality improvement pojects are now required for residents completing their training at a US allopathic medical institution. Compared to traditional research projects in which discoveries can take years to translate to a change in practice, quality improvement initiatives focus on implementing innovative solutions or protocols within the span of days to months. They also tend to be exempt or expedited by institution research regulatory boards.
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More work is needed to help people translate their results to researched-based scientific journals.
Aalap Shah, MD, is a board certified anesthesiologist, specializing in general adult and pediatric anesthesiology.
