Medical Student Elective Catalog: PS/QI-2002/F Patient Safety/Quality Improvement Clerkship - CHATT


Course Coordinators:  Dr. Cy Huffman, Erlanger Chief Medical Officer; Lynne Marks, RN, Clinical

Quality Improvement Coordinator; and Dr. Robert C. Fore, Associate Dean 


Initial Contact:  Dr. Robert C. Fore, Associate Dean and DIO (423) 778-6956.


Clerkship Description

This is an opportunity to participate in a structured, longitudinal curriculum while performing stepwise work on a Patient Safety/Quality Improvement Project (PS/QI Project) under the tutelage of a quality improvement Team Leader.  Students who elect most of their training in Chattanooga should speak with the PS/QI Clerkship Director in Memphis and have her contact Dr. Robert Fore to arrange longitudinal involvement in Chattanooga with QCI and Medical Staff at Erlanger.


Goal:  Students will strengthen their concern for the patient's need to receive quality health care in a safe environment, develop strategies and tools to identify medical errors in patient care and weaknesses in the health care system, and apply those methods to address medical errors and system errors in the health care delivery system.


Students completing the Patient Safety/Quality Improvement Clerkship will:

  1. Describe the STEEEP Principles* as outlined in Crossing the Quality Chasm: A New Health System for the 21st Century, Committee on Quality of Health Care in America, Institute of Medicine (IOM), Washington DC: National Academy Press, © 2001.

*STEEEP Principles

S - Safe - Patients should not be harmed by the care that is intended to help them.  Processes of care delivery will be evaluated and improved to avoid harm to patients, or the potential for harm.

T - Timely - Care should be delivered in a way that avoids long waits and delays.

E - Effective - Care should be based on scientifically accumulated knowledge and evidence, and improve the clinical state or well being of the patient.

E - Efficient - Resources are used in a way that adds the greatest value to the clinical health of the patient.  Waste will be eliminated whenever possible from the delivery process.

E - Equitable - Care does not vary in quality because of personal characteristics such as gender or ethnicity, nor does it vary based on geographic location, time of day, day of week, or a patient's ability to pay.

P - Patient and Family Centered - Planning, delivery, and evaluation of health care are grounded in mutually beneficial partnerships among patients, families, and health care providers.  Care is provided in a way that shows dignity and respect, shares information, encourages participation in care and decision-making, and collaborates on policy and program development.


2.  Understand the importance of improvement in both performance and process in practice and
      health care.
3.  Identify weaknesses in the health care delivery system and medical errors they have
     encountered during their clinical training.
4.  Work as members of a health care team to develop and/or perform a study and make
     recommendations for improving at least one aspect of the health care delivery system.
5.  Prepare a report describing the problem identified and the process for improving performance
     related to that problem. 

Student members on the PS/QI Committee provided these comments collated from the Class of 2006 about their perspectives on this Clerkship: 


"Part of the purpose of working on a Quality Improvement (QI) project as a part of your 3rd and/or 4th year clerkship is to learn how to effectively work with a multi-disciplinary healthcare team on a given problem or group of problems. As a result, satisfactory performance will be judged in part based on your level of involvement with the team to which you are assigned. Although doing away electives or other rotations will not necessarily earn you an unsatisfactory evaluation, if you are going to be away multiple blocks during the work time, you should consider whether that time away will keep you from participating adequately. With e-mail, teleconferencing, and other electronic media available, it is understandable that being away itself may not be a barrier to integrating well. However, you may be asked to participate in the 4-week PS/QI Clerkship during Block 03 of your senior year if you do not work effectively with your team, so take it upon yourself to contact your team or the clerkship course director to discuss your specific circumstances. 


Benefits of QI participation were obtained and collated in discussion with several 4th year students. They agree that the role of the student should continue to be participatory, and not primary. The role of the student should be to learn the process of QI, and the direction of the clerkship should continue to reflect that goal. If you gain any kind of publication from this, it is an obvious benefit. While working with clinical faculty, they may get to know you well enough to be able to write a letter for your residency application. Although not as tangible early on, the following are nevertheless benefits: learning the Plan-Do-Study-Act (PDSA) method, as well as a continuous QI mentality. For example, Medicare is trying to institute Pay-for-Performance which will link your reimbursement to your meeting certain quality indicators (A1C, Blood pressure, etc.). Although it is easy to say, ‘I will be a great doctor, and I will not need to worry about it,' many problems meeting A1C goals are systematic problems, and not problems with knowing the right thing to do. Maintenance of certification requirements will require these skills. Anytime you can work with a team of people who think differently than you, you benefit enormously."

UT College of Medicine Chattanooga     960 East Third Street, Suite 100     Chattanooga, TN 37403     (800)947-7823, ext 6956

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