Quality improvement and patient safety (QIPS) education programmes have proliferated in the past decade given the rising demand for healthcare professionals to develop the knowledge, skills and attitudes required to make improvements in healthcare. On the one hand, this proliferation is a positive sign of the institutionalisation of QIPS within our educational, practice, professional and regulatory spheres. On the other hand, while numerous QIPS education programmes are up and running, our understanding of key educational processes and how to optimise outcomes is still evolving. For instance, it remains unclear how to simultaneously optimise learning and project outcomes in quality improvement (QI) project-based learning or how to facilitate interprofessional learning in QIPS education.
In this issue of BMJ Quality and Safety, Myers and colleagues studied the influence of two postgraduate QIPS fellowship training programme for physicians on graduates’ career outcomes and on the institutions in which they are located. The two programmes, The Center for Healthcare Improvement and Patient Safety Fellowship at the University of Pennsylvania and The Harvard Fellowship in Patient Safety and Quality, provide coursework, access to a Masters degree and opportunities to complete projects within the health system. The study involved interviews with 28 graduates and 16 of their mentors.
The study findings are encouraging in that they demonstrate that these two education programmes had positive effects at different levels. Fellows reported improvements in QIPS knowledge, skills and attitudes and all pursued and completed a Masters degree. A very high percentage of graduates, on completion of their training, held academic and/or organisational leadership positions involved in QIPS administration, research or education. The programmes also attained positive health system outcomes through fellow-led QIPS capstone projects at the divisional, departmental and/or institutional levels. In some cases, the fellows’ impact went beyond their projects and contributed to changes in their institutional cultures through creating dialogue, providing a sense of urgency and momentum for action, shifting conversations from blame to curiosity and raising awareness of improvement science. Mentors described mentees as role models who were paving a career pathway in specialties where QIPS work was less familiar and increasing the acceptability of the field.