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Summary of UT System CS&E program

The University of Texas System Clinical Safety & Effectiveness (CS&E) Course: A Review of Experience in Project-based Quality Improvement Education at Six UT Health Centers

Short description for program: Our experience with the University of Texas System Clinical Safety & Effectiveness Course, a project-based QI training program, is reviewed four years after implementation in the six UT health centers that include 4 schools of medicine, 1 comprehensive cancer center, and 1 health science center. Methods, curriculum, and means of support are described. Results are shared, including number of graduates, interprofessional representation, evidence of continued use of skills, publications/presentations, integration of training into UME and GME curriculum, and estimated return on investment.

Abstract: The UT System CSE course was piloted at MDACC in 2005 and in 2008 a system-wide steering committee began to establish the program into all six UT health centers (4 SOMs, 1 comprehensive cancer center, 1 health science center). The goal of the program is to integrate quality and safety concepts in our everyday work and disseminate successful practices across the UT System. Objectives are the CSE project-based QI course, an annual conference and recognition event, and a CSE Fellowship program. The CSE course is eight days over 5 months, to allow for completion of a project. QI facilitation is included. The course aims to equip a critical mass of clinicians including physicians to lead QI efforts, serve as local faculty for the course, and train the next generation of health professionals in QI. The course is now fully implemented in the six UT health centers. Support is provided by UT System, local institutions, and participating health systems. Nationally known speakers include Brent James, Alan Morris, Jim Reinertsen. Local faculty cover other topics for local relevance and mentoring. Curriculum includes QI theory and tools, data management, evidence-based clinical practices, team skills, patient safety theory and initiatives, quality measures, Lean principles, status of national and international healthcare quality, and health policy.

There are 1297 graduates, completing 418 projects. Alumni are interprofessional, including 39% physicians, 24% nurses, as well as pharmacists, mid-level providers, and healthcare administrators. An annual survey of CSE alumni is conducted. The 2012 survey showed that 68% of CSE projects are still active; 48% have spread the project to other areas of the institution; and 85% continue to use the skills and knowledge in the daily work to improve quality and safety of care. A third of CSE alumni have presented their projects at state and/or national conferences, or published their projects in peer-reviewed journals. The annual conference is a forum to transfer learning and best practices across the UT System. In the fourth year of the conference, 89 abstracts were accepted and 250 participants attended the conference and rated it highly. Awards (recognition and monetary) were given to the top three abstracts. Return on investment for projects presented at the 2012 conference were estimated at $35.9 million, including realized, cost avoidance, and projected savings. Sixteen CSE fellows have been inducted, based on their commitment to service in CSE and continued QI efforts. Many of these efforts include integration of QI and safety training into UME and GME curriculum.

The UT System CSE course has been successful in teaching QI skills to faculty who are actively practicing clinicians and teachers and may serve as a model for faculty development in QI training.