Clinical improvement specialists at Vanderbilt University Center for Clinical Improvement (Nashville, Tennessee, USA) have developed this tool to aid residency programs and other clinicians to comply with Accreditation Council of Graduate Medical Education (ACGME) and Institute of Medicine (IOM) mandates for improving health care. The matrix helps to identify flaws in the system, rather than faults of individuals who work in the system, a key trait of effective quality improvement tools. It also allows residents to express their ideas in a structured format, and gives them a voice of influence in a system in which they are integral contributors.
Background
The matrix has been piloted at Vanderbilt University Medical Center and elsewhere in many specialties, including anesthesiology, psychiatry, nephrology, emergency medicine, and internal medicine/ambulatory.
Directions
The matrix provides a valuable technique for the clinician-educator to zero in on the aspects of care that are most important in the presentation of a given case.
At the conclusion of an episode of care, a resident and his or her attending physician debrief with the following questions, which address all cells in the matrix:
- Was care for this patient as good as it could be?
- What improvements in the competencies of the resident and faculty and changes in the system of care would result in improved care for the next patient?
Read the related article for more explicit directions and examples:
Bingham JW, Quinn DC, Richardson MG, Miles PV, Gabbe SG. Using a healthcare matrix to assess patient care in terms of aims for improvement and core competencies. Joint Commission Journal on Quality and Patient Safety. 2005 Feb;31(2):98-105.
For any questions or to share your feedback about using the matrix, please contact Doris Quinn at MD Anderson Cancer Center (dcquinn@mdanderson.org).
