In March of 2018 I registered for the International Forum on Quality and Safety in Healthcare in Amsterdam, seeking advice and inspiration for what I could do for quality and safety in my home institution. Next week, roughly a year later, I’ll lead a table discussion about junior doctor leadership and share advice for implementing a quality improvement (QI) training program at this year’s International Forum in Glasgow.
We recently kicked off the Amsterdam University Medical Center (UMC) Quality Improvement Academy, an IHI Open School Chapter with a packed curriculum, an energized base, broad institutional support, and a strong leadership team. Next year, this can be your story. I hope that sharing ours will encourage you to follow the single best advice I heard from Don Berwick at the International Forum: Just get started; there is no wrong step to take, as long as you take the first step.
In 2018 I had just finished a master’s degree in Boston, Massachusetts and returned to my home institution in Amsterdam. Electives on quality and safety had sparked my enthusiasm, particularly a guest lecture by junior doctors presenting their own improvement project as the pinnacle of their QI training. The idea that anyone with the right tools can contribute excited me. I was keen to do something. I consulted my former professors and classmates and they advised me to contact the IHI Open School. I went to the IHI website and, although I didn’t find a nearby chapter to join, there was a line of big bold capital letters staring at me: START A CHAPTER. Right underneath was the link to the Chapter Leader toolkit – a comprehensive document packed with guidance on how to get started. Empowered by what I read, I decided this was what I could do.
I applied for a scholarship to the upcoming International Forum. Aside from the financial benefit, this put me on the radar of the Open School team, from whom I’ve enjoyed incredible support from that moment onwards. At the conference I found inspiration from brilliant speakers, advice from the Open School team, and most importantly, the friends and faculty advisors who would help make the Amsterdam UMC Quality Improvement Academy to a success.
Energized by the conference, we registered our new Chapter. Our goal was to design a program that teaches medical professionals the theory and tools of QI and guide them through their first project. The three pillars of the Open School beautifully outline this: Community, building a chapter; Online Courses, teaching the theory and tools; and Project-Based Learning, leading QI projects.
Along with the Chapter charter, we wrote a rough plan for a one-year pilot involving the three major divisions of our hospital: Anaesthesiology, Surgery, and Internal medicine. Over the course of six months participants would complete the Basic Certificate in Quality & Safety and apply their new knowledge to their own project. Monthly seminars with guest speakers on related topics, group discussion of the course material, and eventually, progress reports of the projects would form the backbone of our activities. Our advisor agreed to recruit coaches among his peers.
We prepared a one-page summary and went looking for support, keeping emails concise and clear so they could be read in a glance. With each layer in the hierarchy, we explicitly mentioned and copied those who had already pledged their support. At last, we wrote to the board of directors with support of the residency program directors, nursing heads, department heads, and our faculty advisor. In addition to their symbolic support, we requested €3,000 for each department and €1,000 for operational costs, a total of €10,000. It took some nail-biting weeks before we got a response, but finally we received good news: our proposal found broad support in the board and the funding was granted. We were ready to get going!
Each residency director brought forward an additional member for the leadership team, and together we’ve worked towards the kick-off last month. The Open School team advised us on how to best organize the course material and prepare the coaches for their role. The residency directors and head nurses helped us recruit enthusiastic participants, and our faculty advisors (two by now, as one of the residency directors joined the pack) helped us place the project within our institution’s broader QI community. We pieced together a diverse program with renowned speakers including the director of the national Health Care Inspectorate, a cognitive psychologist, clinicians, and a human factor engineer. The well-attended, interactive monthly seminars now serve both as education and also as a platform for discussion and collaboration for the broader QI community in our hospital.
We still have a long way to go and look forward to an incredibly exciting first year. So far, the Amsterdam UMC Quality Improvement Academy has been a great success. We think some important factors include diverse leadership and committed faculty advisors. But obviously, we were very lucky to find such fertile ground, broad institutional support, and the incredible resources of the Open School. All our project needed was ignition. It might not always be this easy, but unless you get started, you’ll never find out. With all the resources in place, there’s just no excuse. Good luck!
Learn about the Open School and Chapter network in our free course, OS 101: Introduction to the IHI Open School, or check out the Chapter Leader Toolkit for more advice on creating and sustaining Chapter leadership.
Stijn de Jonge is a junior doctor and Chapter Leader at University Medical Center Amsterdam.