Objective & Background
In April 2009, we asked each Chapter Leader complete the first semi-annual Chapter Progress Report. Collecting information on activities, needs, and progress in the field continuously is challenging. As such, the IHI Open School developed the progress reports to gauge overall Chapter Progress, successes, challenges, identify high-performing Chapters, and recognize Chapter needs.
Survey Design & Participants
The IHI Open School team developed a thirty-seven question survey delivered via Survey Monkey’s online survey tool. The progress report was submitted to the Student Advisory Group and Student Editorial Board for review. Feedback was collected and used to modify the survey tool. Weekly reminders were sent over the course of a month to obtain a meaningful response rate. Surveys were mailed to all enrolled Chapter Leaders. Chapter Leaders are students, faculty, or health professionals.
Results
Chapter Support
82 of 102 unique responders completed the survey, yielding an 80% response rate. Progress reports were sent to each Chapter Leader for the Chapters, but it was only necessary for one Chapter Leader to complete the report for the Chapter. 78% of the Chapters reported having a Faculty Advisor. In some cases, the Faculty Advisor is also the Chapter Leader. 33% of the Chapters who indicated they have a Faculty Advisor reported their Faculty Advisor is “active in helping us plan and deliver activities for members.” 33% of the Chapters reported having more than one Faculty Advisor. 48% of the Chapters are recognized by their college or university as an official student organization; however, 10 of the Chapters that responded are based at hospitals, not universities. 56% of the Chapters are based at schools that can obtain funding from multiple departments. Again, 10 of the Chapters were not based on university campuses. Only 26% of the Chapters are funded. 13% obtain funding from their university or campus organization funding sources and 13% are funded by their department or program of study. Other funding for university-based Chapters is obtained from local health systems and the government by way of a local hospital (international Chapters).
Chapter Leadership
We asked Chapter Leaders “Why did you start an IHI Open School Chapter on your university or hospital campus?” While the question was met with a variety of answers, a few themes emerged. Chapter Leaders have an interest in quality improvement and patient safety, a strong desire to improve the healthcare system they are about to enter, they want to raise awareness on their campus, and they want to teach other students about quality improvement and patient safety.
Chapter Leaders were asked to indicate how their Chapter Leadership is chosen – (volunteer, Chapter vote, or other). 67% of the Chapter Leaders are volunteers, while only 6% are elected.
Chapter Membership
Chapter Leaders reported their Chapter membership ranges from one to 1,200 members. The 1,200 membership size is due to the requirement for students to complete IHI Open School courses for a particular school. Other schools have similar requirements. The average Chapter size was 15 members. Chapter Leaders recruit members by collecting interested students’ email addresses, contacted faculty, and contacted friends in other programs of study. Chapter Leaders indicated their most successful recruitment methods include email (78%), contacting faculty (55%), word-of-mouth/recruiting friends (48%), making announcements in class (46%), using the IHI Open School posters (28%), faculty advertise in class (28%), advertising through other student organizations (27%), and one-on-one conversations. Many of the students note the difficulty they have in explaining the IHI and the importance of quality improvement and patient safety to their colleagues.
Creating an Interprofessional Chapter
Chapter Leaders were also asked to share how they engage students from other health professions schools in their Chapter. 76% collected interested students emails; 55% contacted faculty; 55% contacted friends in other programs of study; 35% made an announcement in class; 33% advertised with IHI Open school posters; 29% advertised through a campus listserv; 27% Faculty Advisor advertised during his/her class; 25% advertised through other student organizations; 14% advertised during a student organization far; and 10% added their Chapter to their school’s website.
A few of the Chapter Leaders have developed creative ways to recruit their colleagues. For example, the Chapter Leader at Emory talks with students about their frustrations in the clinic and explains the IHI Open School is a constructive solution for addressing their frustrations. Most Chapter Leaders track their Chapter membership via email and meeting sign-in sheets.
Chapter Activities & Events
43% of the Chapters have 1-2 Chapter meetings per month while 18% of the Chapters don’t conduct meetings and 12% meet virtually. 77% of the Chapter Leaders have joined an On Call Audio Conference. 41% of the Chapter Leaders have hosted events for students interested in quality improvement and patient safety, 11% hosted relevant journal club discussions, and 19% completed case study reviews with others students. 34% of the Chapters reviewed courses or other IH Open School content with their Chapter members. Chapters have operated primarily on an individual basis; only 8% of the Chapters have hosted events for Chapters in his/her region. Chapter Leaders desire hands-on experience in local quality improvement projects. In fact, 20% of the Chapter Leaders have participated in local or national quality improvement projects. Additionally, many of the Chapters have hosted guest speakers, collaborated with local IHI initiatives, or have ongoing Chapter projects. Many of the Chapters have contacted quality and patient safety leaders at local health organizations to invite guest speakers to Chapter meetings, to inquire about Chapter project opportunities, and to request a site visit to the healthcare organization.
IHI Open School Resources
54% of the Chapter Leaders indicated their faculty use Open School resources in their courses. As a reminder, 10 of the Chapters are not based at universities. The most common IHI Open School resources used include the online IHI Open School courses and On Call Audio Conference recordings, followed by various videos and literature. These resources are used in a variety of ways: class discussion, homework, noon conference, and in Chapter meetings.
Communication & Interaction with IHI
39% of the Chapter Leaders have joined at least one monthly Chapter Call and 10% have joined five or more calls. 27% report never joining a monthly Chapter Call. Overall, feedback about the Chapter Calls was positive – Chapter Leaders enjoy hearing what other Chapters are doing and hearing updates and information about upcoming events from the IHI Open School team. Chapter Leaders wants the IHI Open School team to continue hosting monthly Chapter Calls. The time and date of the calls is difficult, but they indicated they do listen to the recordings at a later time. Chapter Leaders noted the Chapter Calls are focused on students. Since some of the Chapter Leaders are faculty, they would like faculty calls. Beginning in July 2009, the IHI Open School team will host periodic calls for faculty. Many of the Chapters noted having interaction with a member of IHI – Shannon Mills, an IHI fellow visited, or an IHI faculty member visited their campus. A few of the Chapter Leaders attended local IHI events, while it was more common the Chapter Leaders attended the National Forum, International Forum, US Chapter Congress, or UK Chapter Congress. Chapter Leaders were asked “how have you interacted with IHI?” 25% of the Chapters indicated an IHI Open School team member has visited his/her campus; 10% have hosted an IHI Faculty member or Fellow; 31% attended the IHI Open School Chapter Congress; 49% attended the IHI National Forum; 13% attended the IHI/BMJ International Forum; and 76% have joined an On Call Audio Conference.
Accomplishments
Chapter Leaders were asked to share their biggest accomplishments. Bringing different health profession schools together, raising awareness about quality improvement, obtaining support from local hospital leadership, recruiting/increasing Chapter membership, and simply getting started were among a few of the most common shared accomplishments. The University of North Carolina, Chapel Hill reports, some professors give credit to students for attending IHI Open school meetings and events. Several of the Chapter Leaders also noted bringing students and faculty from multiple health profession programs as the greatest accomplishment, and, one of the goals of the Open School Chapters. 28% of the Chapter Leaders indicated they are graduating this year!
Other noteworthy Chapter accomplishments are listed below.
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Duke University identified several projects for students and helped contribute to the ongoing curriculum reform. The Chapter Leaders met with faculty leaders and recently, the Chapter President spoke to the Board of Visitors for the School of Medicine on interdisciplinary education and student involvement in quality improvement and patient safety. The Chapter Leader participated in a national essay contest with other Chapter Leaders sponsored by MD Connector and the Mayo Clinic – they were finalists!
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Harvard University hosted the IHI Open School Boston Regional Event! A few of the Chapter members are also involved in planning a national student project to facilitate implementation of the WHO Surgical Safety Checklist. Of note, two of the Chapter Leaders persuaded leadership at hospitals in Pakistan and Israel implement the checklist. One of the Chapter Leaders presented the IHI Open School at a grand rounds presentation and a memorial presentation at a different hospital. The Chapter also scheduled a lecture series featuring guest speakers who speak about topics related to quality improvement and patient safety.
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Massachusetts General Hospital Institute of Health Professions assisted in planning the IHI Open School regional event. Chapter Leaders and the Faculty Advisor were instrumental in engaging the school’s academic committee. The committee invited members of the IHI Open School team to present, obtain feedback, and share the IHI Open School resources.
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University of California – San Francisco hosted an IHI fellow, Dr. Robson, as a guest speaker at Chapter meeting. The Chapter Leader presented to the group of health care leaders at the 2008 IHI National Forum. The Chapter also successfully published an article in its school newsletter about their Chapter.
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Saskatchewan Chapter (University of Saskatchewan, University of Regina, & SIAST College) persuaded student leadership at the university to agree to take on the IHI Open School as a committee activity. Over 100 students have completed IHI Open School courses as part of their QI curriculum in 2009.
- Stanford University obtained support for their Chapter by scheduling meetings with the Dean of the School of Medicine, Dean of Medical Education, and several faculty members. They are modifying a leadership course in the medical school to include quality improvement and may develop an elective track for students interested in quality improvement. They also plan to conduct a quality improvement project at their student run health clinic.
- Texas Tech University Health Sciences Center held its first meeting and had twenty attendees! The Chapter Leader participated in a national essay contest with other Chapter Leaders sponsored by MD Connector and the Mayo Clinic – they were finalists!
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University of Oslo & Kollegium Qulturum presented the IHI Open School at the General Assembly of the International Federation of Medical Students (IFMSA) in March 2009. The Chapter Leaders and Faculty have used Open School/IHI content to train almost 70 students in Trondheim, Norway, Copenhagen, Denmark, and Hammamet, Tunisia!
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University of San Diego provided education to its members about quality improvement, patient safety, and patient advocacy. Their Chapter has excelled in connecting research, contemporary health care principles, and translating it into modeling improvement for clinical practice. They’re planning a regional Chapter meeting, are discussing plans for community service projects, and may organize their Chapter members to collectively petition for change at the state legislative level!
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University of Toronto toured the Human Factors lab with the Chapter in April, plans to partner with a regional hospital to do an improvement project, and plans to work with a newly founded organization for Patient Safety based at two teaching hospitals.
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Vanderbilt University reached out to most of the key quality improvement stakeholders at Vanderbilt University, Vanderbilt University Medical Center, and received enthusiastic support. They recruited a small, but influential cadre of mentors: five physicians participating in the VA Quality Scholars Program at Vanderbilt University and their affiliated VA Hospital. With the successful recruitment of a dozen rising second-year medical students, they are embarking on their first quality improvement project this summer at their student-run clinic: the Shade Tree Family Clinic. In the meantime, they have scheduled meetings with student leaders from both the School of Management and the School of Nursing to expand membership to their sister schools.
