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  1. A house officer-sponsored quality improvement initiative : leadership lessons and liabilities.

    Article - En anglais

    Background 

    House officers play an important role in the care of hospitalized patients, yet they are infrequent participants in quality improvement (QI) activities.

    A grassroots QI initiative among medical house officers was implemented at Beth Israel Deaconess Medical Center's East Campus in Boston from 1995 through 1997.

    Findings 

    A group of house officer volunteers completed five of nine projects, including a survey that demonstrated frequent failures of cardiac monitor-defibrillators in the emergency room.

    Reaching out to key administrators produced several quick fixes.

    Developing effective, ongoing partnerships with clinical departments and QI professionals proved more problematic.

    Discussion 

    Residency training programs that provide experience in QI give house officers a potentially valuable skill and an additional means to improve the quality of patient care.

    Yet many obstacles work against house officers'participation in QI initiatives, including long hours and the daily demands of patient care, rotating monthly assignments, and clinical leaders'assumption that they have little interest in QI.

    The organizers of the officer problem-solving group over-estimated the hospital resources at their disposal and failed to build mechanisms to ensure the intitiative's continuation into its second year, when their own interest waned and no new group of leaders emerged to take their place.

    Conclusion 

    Hose officers represent an underused resource for QI. (...)

    Mots-clés Pascal : Interne(étudiant), Milieu hospitalier, Personnel sanitaire, Etudiant, Hôpital, Médecine, Soin, Amélioration, Processus, Méthodologie, Médecin, Organisation hospitalière, Qualité

    Mots-clés Pascal anglais : Resident(student), Hospital environment, Health staff, Student, Hospital, Medicine, Care, Improvement, Process, Methodology, Physician, Hospital organization, Quality

    Notice produite par :
    ORS Auvergne - Observatoire Régional de la Santé d'Auvergne

    Code Inist : 002B30A11. Création : 19/02/1999.