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BWH has offered a “Joint Class,” a pre-operative education class for patients undergoing a primary total hip arthroplasty, for more than 10 years. But before this spring, there was no uniform way for patients to find out about the class.
“Some people were told by surgeons about the class, and others were told by schedulers,” said Roya Ghazinouri, PT, DPT, MS, clinical supervisor for Inpatient Physical Therapy. “The timing of the joint class and pre-operative evaluation date rarely coordinated, requiring patients to make two or even three trips to the hospital to complete their pre-op evaluation and education.”
This spring, Ghazinouri and John Wright, MD, set out to change that. They were one of five BWH teams to complete Partners’ Clinical Process Improvement Leadership Program, or CPIP, which is modeled after Intermountain Healthcare’s miniAdvanced Training Program in Salt Lake City.
“The Intermountain course focuses on ways to engage clinical practitioners in their clinical spaces,” said Jessica Dudley, MD, chief medical officer, Brigham and Women’s Physicians Organization, who completed the Intermountain training program in 2008, along with seven others from the Partners network. “We all found it incredibly useful, but we knew if we wanted to have cultural change in this space, we would do better having our own version of this course.”
Dudley and Michael Gustafson, MD, MBA, senior vice president of the Center for Clinical Excellence, now represent BWH on the CPIP steering committee. After the decision was made to replicate the course for Partners organizations, a second group of Partners clinicians traveled to Salt Lake City, this time with the mission of learning to implement the program in Boston.
“The Brigham has played a unique role in this Partners-level initiative. Michael and Jessica have both been instrumental in raising awareness of the course and designing its curriculum,” said Sandhya Rao, MD, CPIP co-course director, who was among the second group of Partners employees to complete Intermountain’s program.
“The goal of the CPIP is to provide front line clinicians with tools, such as a process mapping and variation analysis, to improve clinical outcomes by addressing the underlying processes of care,” said Rao. “It combines lessons from Intermountain with the Lean methods for process improvement and uses an array of teaching methods, including seminars, expert panels, case examples and small group sessions.”
Participants also complete a team clinical process improvement project during the 12-week course, allowing them to translate theory into action.
“It’s a demanding course,” said Rao, a BWH physician and leader of High Performance Medicine Team 5, which sponsored the course. “Quality improvement is hard, and this course gives people a taste of the challenge in a very compressed time frame.”