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Apply Today! – New Pursuing Excellence Pathway Leaders Patient Safety Collaborative

The ACGME is seeking up to 15 ACGME-accredited Sponsoring Institutions to participate in the 18-month Collaborative. Teams selected to participate will develop and test a new model for equipping resident and fellow physicians with the skills they need to engage in systems-based approaches to delivering safe, high-quality care throughout their careers.

Call for Applications – New Pursuing Excellence Pathway Leaders Patient Safety Collaborative

Apply to be part of the Collaborative


On May 1, 2019, the CLER Program held an informational webinar on the new Pursuing Excellence Pathway Leaders Patient Safety Collaborative. Those interested in learning more about the Collaborative can view this presentation using the link below.

View Informational Webinar

Highlights from Pathway Leaders Learning Session 2 at the ACGME
Highlights from Quality Improvement in Health Care Disparities Leaders Learning Session 1 at the ACGME

Pathway Leaders Update — Quality Improvement in Health Care Disparities


The Pathway Leaders Quality Improvement in Health Care Disparities Collaborative met at the ACGME offices in Chicago, Illinois February 5-7, 2019, for its first Learning Session. The Collaborative, part of the ACGME's Pursuing Excellence in Clinical Learning Environments (Pursuing Excellence) initiative, consists of teams from nine ACGME-accredited Sponsoring Institutions seeking to understand, identify, and eliminate health care disparities within their clinical learning environments (CLEs). The goal of the Collaborative is to assist teams in designing strategic plans focused on quality improvement to eliminate health care disparities in their CLE. Key elements include enhanced educational programming for cultural humility and a strategy to prepare residents and fellows to identify and eliminate health care disparities that contribute to health inequity.

At the beginning of the session, teams shared an overview of the individual projects that they proposed for the Collaborative. The presentations highlighted the diversity and uniqueness of each of the team's patient and workforce populations, and the different approaches that the teams were taking to advance equity in care.

After sharing their projects, teams were invited to consider the implications of how institutional structures can create health inequity as Collaborative faculty member Camara Jones, MD, MPH, PhD of Morehouse School of Medicine presented an allegory on the roots of racism. Reflecting on their own experiences, teams identified overarching systems of inequity and opportunities for change.

Day two addressed the topic of personal and system biases and how the health care system can reduce bias in patient care. Collaborative faculty member Ronald M. Wyatt, MD, MHA of Cook County Health and Hospital System shared how many types of inequity can be independent risk markers for health care disparities. His presentation highlighted how health inequities and health care inequities are different yet interrelated issues.

A theme that emerged early in the session was the need to develop a common language for addressing the complexities of health equity, health disparities, and health care disparities.

Over the next eight months, the Collaborative's faculty members will continue to assist teams in the development of strategic plans focused on quality improvement to eliminate health care disparities in the CLE. The teams will return to the ACGME for a second Learning Session June 12-14, 2019.

Pathway Innovators Update — An Interprofessional Clinical Learning Environment Comes into Focus


In early January 2019, the Pathway Innovators—one of several Collaboratives organized as part of the ACGME's Pursuing Excellence in Clinical Learning Environments (Pursuing Excellence) initiative—convened for their eighth Learning Session, hosted by Children's National Medical Center in Washington, DC, with support from the Association of American Medical Colleges (AAMC), an initiative partner organization. During the session, participants engaged in a variety of activities to explore innovation in the clinical learning environment (CLE).

The Learning Session kicked off with a panel discussion on the topic of current challenges and opportunities in health care. Tonya Vidal Kinlow, MPA, vice president of Community Engagement, Advocacy, and Government Affairs of Children's National Medical Center moderated the discussion. Jim Kaufman, PhD, cice president of Public Policy at the Children's Hospital Association, and Janis Orlowski, MD, chief health care officer of the AAMC, served as panelists. The panelists shared perspectives on how market forces are impacting physician education and training, how access to information and advances in technology are changing patients' relationships with and expectations of health care providers, and how medical education could explore novel, agile, and continuous ways to prepare the physician workforce.

The Collaborative teams participated in a design activity to conceptualize and build physical representations of their current CLE and their future ideal CLE, focusing on the roles and infrastructures that could support their goal of a highly functioning interprofessional CLE. By comparing the current state of their CLE with the ideal state, teams were able to identify previously unseen gaps in their strategic plans. In particular, they identified the need for different types of infrastructures to facilitate high-performance teaming, with partnerships between clinical delivery, research, information science, and graduate medical education. Teams also noted that the interdependency of stakeholders highlighted the need for a centralized function to create and maintain infrastructure. The teams also emphasized that organizational systems need to be centered around patients and their families.

On the third day, teams worked on advancing their local projects through a tool-sharing opportunity entitled "Gizmos, Gadgets, and Widgets." The emphasis of this activity was on providing tips, tricks, and tools to assist in the elevation of team-based culture.

The next Pursuing Excellence Pathway Innovators session will be hosted by the Cleveland Clinic (Ohio) in May.

Highlights from Pathway Leaders Learning Session 2 at the ACGME
Highlights from Patient Safety Leaders Learning Session 3 at the ACGME

Pathway Leaders Update — Patient Safety in the Clinical Learning Environment (CLE)

The Pathway Leaders Patient Safety Collaborative met at the ACGME&'s offices November 14-16, 2018, for its third and final Learning Session. The goal of the Collaborative is to contribute to individual and collective learning by developing a framework and plan for engaging all residents and fellows in patient safety during their first 12 months of clinical education and training.

This final Learning Session focused on sustainability. In particular, Collaborative members discussed how clinical learning environment leaders can "pull" learners into their operations, seeing residents and fellows as a valuable asset. Teams indicated the key to this shift is creating a partnership between patient safety and graduate medical education leaders.

All teams also reported on the progress of their common goal to have 100 percent of their current first-year residents and fellows complete a real patient safety event analysis. While one team reached 100 percent, the others had engaged between less than one and 50 percent of residents and fellows, with six months left to achieve this goal.

In reporting their progress, teams had the opportunity to share and reflect on their individual challenges in engaging residents and fellows in patient safety event analysis at their institutions. They identified the elimination of organizational silos, alignment with institutional goals to sustain a clinical learning environment "pull" system, and learner metrics as steps needed to achieve a culture of safety.

In a presentation on measurement, Rachel Kelz, MD, of the University of Pennsylvania challenged teams to be creative in their approach to measuring patient safety success. "The return on the investment does not always have to be dollars," she explained.

Overall, collaborative teams reported their experience had provided them with an enhanced understanding of the value of partnerships and shared learning. One of the biggest challenges teams have faced is the need to develop intentional partnerships outside of organizational silos. Teams are finding that these partnerships can make or break the success of any patient safety program.

Members of the Pathway Leaders Patient Safety Collaborative will share lessons learned from their journey during a Sunset Session on Friday, March 8 at the 2019 ACGME Annual Education Conference in Orlando, Florida.

Pathway Leaders Update — Patient Safety in the Clinical Learning Environment (CLE)

The Pathway Leaders Patient Safety Collaborative met at the ACGME offices May 7-9, 2018 for its second Learning Session. This Collaborative’s goal is to contribute to individual and collective learning by developing a framework and plan for engaging all residents and fellows in patient safety during their first 12 months of clinical training.

The Collaborative’s second Learning Session focused on engaging learners in patient safety event analysis. The session began with all teams presenting a storyboard describing a small authentic event analysis process they are testing. Storyboards included each team’s planned criteria, improvements, assessment of learners, transmission of results to the patient safety office, and implementation timeline. Teams provided input to each other’s storyboards and made adjustments according to the feedback they received.

Key themes that emerged from the session included: patient safety recognition and reporting; partnership with the patient safety office; recognizing the CLE safety culture; and assessment of learner experience.

Teams discussed how engaging residents in small patient safety event analysis early in their educational programs can inspire them to take part in a culture of reporting patient safety events, including close calls, because they understand the value of reporting as part of the CLE’s quality improvement efforts.

By partnering with their institution’s patient safety event office to examine institutional stakeholders and underutilized resources, teams were able to leverage patient safety and graduate medical education expertise to develop comprehensive plans aligned with their organization’s needs.

The Collaborative will meet again in November 2018.

Pathway Innovators Update — Interprofessional Clinical Learning Environment at Learning Session 6

On May 22-24, 2018, the Pathway Innovators—one of several Collaboratives formed as part of the Pursuing Excellence in Clinical Learning Environment initiative—had their sixth Learning Session at Maine Medical Center in Portland. The Innovators are wrapping up Year 2 of their four-year journey to promote transformative improvement in the CLEs of ACGME-accredited institutions.

The Innovators brainstormed how to build the capacity to position graduate medical education to be viewed as a strategic asset—understanding that transformational change in the CLE will require partnership between graduate medical education and CLE leaders. They also focused on how to maximize shared learning with coordinated educational resources across health professions. In particular, the teams reviewed lessons learned from Maine Medical Center’s iPace unit, a small interprofessional unit built from the ground up.

The Pursuing Excellence Innovators meet in September, January, and May of each year. Find out more at the ACGME Annual Educational Conference in March 2019.

Contact Us

Morgan Passiment
Director of Institutional Outreach and Collaboration
Phone: 312.755.5012

Patrick Guthrie
Program Coordinator, Institutional Outreach and Collaboration
Phone: 312.755.7468

E-mail: PEI@acgme.org


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