The IHI Open School Chapter at Brock University, in Ontario, Canada, is one of the most active in the Open School community. Recently, Brock University and its partners won a $41,000 grant to support an innovative elective they created to provide students with hands-on experience doing quality improvement projects with a nearby health system. Needless to say, winning such a large sum for quality improvement education isn’t a situation most Chapters find themselves in, so we reached out to Madelyn Law, PhD, the Chapter’s Faculty Advisor and Associate Professor of Health Sciences, to tell us more.

Madelyn Law, right, with students in the I-EQUIP program. Photo credit: McMaster University

OS: How did you realize the need for quality improvement in the curriculum?

ML: I had an informal conversation with Dr. Karl Stobbe who is the Assistant Dean of the Michael G. DeGroote School of Medicine McMaster University – Niagara Regional Campus, and we identified a major gap in the education for our students — they were not exposed to the concepts of quality and systems issues in health care. We thought this was a great opportunity for our organizations to collaborate with each other and work with the community to both improve the health system and teach our students about quality.

OS: What is the Interprofessional Education for Quality Improvement Program (I-EQUIP)?

ML: I-EQUIP was developed in partnership with the Niagara Health System, McMaster University, and Brock University. This program is open to students at the Michael G. DeGroote School of Medicine at McMaster University and Brock University, as well as current health system staff, in a collaborative learning program. The purpose of I-EQUIP is to provide an interprofessional learning experience for health professionals and students through health care system understanding, quality improvement education sessions, and applied projects. 

OS: How does it work?

ML: The program consists of three workshops, three hours each, and online IHI Open School educational modules. Project teams with one McMaster medical student, one Brock Student, and a health system partner work to develop, implement and evaluate quality improvement projects through the Model for Improvement framework. This is supported through a mentorship model with senior students who were previously involved in the program and existing health system quality advisors. 

 

OS: What results have you seen so far?

ML: In 2012-2013, we piloted I-EQUIP for the first time, and the program demonstrated effective quality improvement and patient safety knowledge acquisition. Twenty students participated in projects focused on sepsis identification at triage, insulin safety, venous thromboembolism prophylaxis, antimicrobial stewardship, and post-discharge telephone calls, all within the hospital setting. We were very happy to see that other health professionals were interested in these projects, and students presented six posters at the local Annual Health Quality Symposium, four posters at the National Health Leadership Conference in June 2013, and two posters at Health Quality Ontario in November 2013. 

During our second year of I-EQUIP, from 2013-2014, the projects were extended to two years in length, and expanded to include work in the long-term care and rehabilitation settings. During this year, 50 students participated in projects focused on sepsis identification in long-term care, preventing falls, insulin safety, mental health, reducing surgical site infections, transitions of care between the hospital and rehabilitation, emergency department flow, antimicrobial stewardship, patient satisfaction, volunteer education in the emergency department, secondary stroke prevention, a new physical form in long-term care, and preventing unnecessary hysterectomies. All of these projects were presented at the Second Annual Health Quality Symposium in April 2014. Given that the projects are two years in length, these students will be continuously implementing small cycle improvements and collecting data with an anticipated completion date in April 2015.  We are now in our third year and have another 10 projects and engaging another 50 students and staff.

I-EQUIP students present their projects at the Health Quality Symposium in 2014. Photo credit: Brock University

OS: How did you manage to create such a dynamic program in the midst of your regular work?

ML: I have relied heavily on my desire to make this work even though it is not part of my normal workload at Brock. However, due to the success of the program, I am now able to count this program toward teaching credit. We’ve also been lucky to have Dr. Matt Greenway, who is the lead at the medical school, who has helped to raise the profile of this program in the medical school. As well, the health care organizations have come to understand their role and the value of the program, and we now have the Vice President of Quality and Strategy at the Niagara Health System, Linda Boich, as a co-director of the program.

In terms of financial sustainability, we are using the Canadian Medical Protective Association grant that we received to pay  for a  research assistant who is also the coordinator of the program, as well as small internal Brock and McMaster University grants to provide support for the logistics of the workshops and projects.

OS: How did you learn about the grant?

ML: Google. As an academic, I am always looking for granting opportunities, and I was searching for grants in the area of patient safety and quality, and this one came up.

OS: Why do you think you were chosen to receive this grant?

ML: I think the unique collaboration between the organizations is one reason. I also believe that quality and patient safety is receiving greater attention in Canada with Health Quality Ontario and accreditation bodies in medical schools, so I believe that these were factors in the selection. As well, our research design to evaluate the students’ learning involved a mixed method approach with surveys and qualitative interviews, which I believe strengthened the applicability of the results we will obtain.

OS: If you could give other Chapters one tip on applying for outside funding, what would it be?

ML: Ensure that you are able to link the work that you are doing to key theoretical models, for example, Kirkpatrick’s model of learning, which will strengthen the proposal. Ensure that you are clear on the objectives and the alignment of the objectives to the actual methodologies you will use. Ensure the proposal clearly outlines that you are doing research on the quality improvement educational process and not the QI projects themselves. Although, that depends on what you are applying for. We applied to evaluate I-EQUIP and not specifically the QI projects.

OS: How did you feel when you found out about the grant, and what did you do immediately after getting the news?

ML: It was fantastic feeling. It’s difficult to find research funding, and I know that it’s quite competitive.  The first thing I did was let the other investigators know, and I told our department chair and research communications person. Then I took the rest of day off. J