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Hardin-Fanning F, Booth A, Clark P, Baltes A. Empowering nursing council implementation science: An appeal to action. Nurs Outlook 2024; 72:102199. [PMID: 38821000 DOI: 10.1016/j.outlook.2024.102199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 05/03/2024] [Accepted: 05/04/2024] [Indexed: 06/02/2024]
Abstract
BACKGROUND In most hospitals, nursing councils are responsible for EBP implementation and evaluation. To enhance the perceived value of council participation by frontline nurses, administrators must promote the impact of council projects on healthcare outcomes. PURPOSE The purposes of this appeal to action are to describe the role of nursing councils in promoting IS and EBP, and to provide recommendations that enhance the value of IS and/or EBP councils to frontline nurses, thereby incentivizing participation on these councils. METHODS Nurse researchers from three metropolitan hospitals partnered with a medical librarian to recommend six strategies aimed at enhancing the perceived value of council participation. An argumentative review was conducted to support these strategies. DISCUSSION Recommendations are inclusion of methods experts on councils; support from nursing administrators in the development, implementation, and evaluation of projects; formation of partnerships with nursing academic departments; expansion of publication opportunities and availability; and connection of projects to measurable quality indicators. CONCLUSION Enhancing the perceived value of nursing councils by providing tools that optimize time and resource management can result in greater council participation and broader dissemination of IS evidence.
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Affiliation(s)
| | - Adam Booth
- University of Louisville Health, Medical Plaza II, Louisville, KY
| | - Paul Clark
- University of Louisville School of Nursing, Louisville, KY
| | - Amie Baltes
- Rowntree Library, University of Louisville Hospital, Louisville, KY
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Sara SA, Schwarz A, Knopp MI, Warm EJ. Twelve tips for creating a longitudinal quality improvement and safety education for early health professions students. MEDICAL TEACHER 2024; 46:330-336. [PMID: 37917988 DOI: 10.1080/0142159x.2023.2274137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2023]
Abstract
Despite the numerous calls for integrating quality improvement and patient safety (QIPS) curricula into health professions education, there are limited examples of effective implementation for early learners. Typically, pre-clinical QIPS experiences involve lectures or lessons that are disconnected from the practice of medicine. Consequently, students often prioritize other content they consider more important. As a result, they may enter clinical settings without essential QIPS skills and struggle to incorporate these concepts into their early professional identity formation. In this paper, we present twelve tips aimed at assisting educators in developing QIPS education early in the curricula of health professions students. These tips address various key issues, including aligning incentives, providing longitudinal experiences, incorporating real-world care outcomes, optimizing learning environments, communicating successes, and continually enhancing education and care delivery processes.
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Affiliation(s)
- S Anthony Sara
- College of Medicine, University of Cincinnati, Cincinnati, OH, USA
| | - Anna Schwarz
- Department of Internal Medicine, College of Medicine, University of Cincinnati, Cincinnati, OH, USA
| | - Michelle I Knopp
- Division of Hospital Medicine, Cincinnati Children's Hospital Medical Center, Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OH, USA
| | - Eric J Warm
- Department of Internal Medicine, College of Medicine, University of Cincinnati, Cincinnati, OH, USA
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Bird CM, Kaushal S, Trivedi MK, Moore JA, Sheth SS. Efficacy of a Longitudinal Project-Based Quality Improvement Curriculum in Pediatric Cardiology Fellowship. Pediatr Cardiol 2023:10.1007/s00246-023-03340-5. [PMID: 37966519 DOI: 10.1007/s00246-023-03340-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Accepted: 10/25/2023] [Indexed: 11/16/2023]
Abstract
Quality improvement knowledge is a requirement of fellowship training. Our goal was to evaluate the efficacy of a 3-year quality improvement and patient safety (QI/PS) curriculum that gives fellows both didactic knowledge and first-hand experience with improvement science, and meets Clinical Learning Environment Review (CLER) requirements. Knowledge assessment is obtained through pre- and post-surveys. A secondary measure of success is academic products resulting from fellows' QI/PS work, and future participation in QI/PS efforts. Since 2019, 51 pre-tests and 36 post-tests were completed, showing improvement across all competencies. Fellows have produced one published manuscript, two poster presentations, and two oral presentations describing their improvement work. Additionally, mentoring faculty members have gone on to lead other QI work throughout the division. This longitudinal QI/PS curriculum provides both knowledge and experience in QI/PS work. It also creates opportunities for academic publications and presentations, builds faculty expertise, and most importantly, works to improve multiple aspects of patient care. This curriculum can serve as a model for other cardiology fellowships working to meet CLER requirements.
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Affiliation(s)
- Cara M Bird
- Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA
| | - Sonia Kaushal
- Division of Cardiology, Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA
| | - Mira K Trivedi
- Division of Cardiology, Department of Pediatrics, Riley Children's Hospital, Indiana University, Indianapolis, IN, USA
| | - Judson A Moore
- Division of Cardiology, Department of Pediatrics, Primary Children's Hospital, University of Utah, Salt Lake City, UT, USA
| | - Shreya S Sheth
- Division of Cardiology, Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA.
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Lavin J, Kao LS. Building infrastructure to teach quality improvement. Semin Pediatr Surg 2023; 32:151283. [PMID: 37147216 DOI: 10.1016/j.sempedsurg.2023.151283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
With growing emphasis on healthcare quality improvement (QI) at both national and local levels, there has been increased demand for instructional programs to teach quality improvement as a discipline. Design of QI teaching programs must take into account local resources as well as the background and competing commitments of the learner. In this article, we review elements of successful quality improvement training programs including structure of didactic and experiential curricula. Special considerations for training programs at the undergraduate and graduate medical, hospital, and national/professional society level are presented.
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Affiliation(s)
- Jennifer Lavin
- Division of Pediatric Otolaryngology - Ann & Robert H. Lurie Children's Hospital of Chicago Associate Professor, Department of Otolaryngology - Head and Neck Surgery - Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
| | - Lillian S Kao
- Division of Acute Care Surgery Vice-Chair for Quality, Department of Surgery McGovern Medical School at the University of Texas Health Science Center at Houston, Houston, TX, USA
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Abstract
OBJECTIVES The objective of this article is to present a comprehensive view on the topic of nursing leadership discussing the theoretical frameworks that underpin its manifestation, the leadership styles in nursing, the overall landscape in nursing leadership including the context where leadership is being practiced, and finally looking at the educational pathways for building leadership capacity and sustainability DATA SOURCES: Relevant studies on the topic as well professional associations, national and international organizations' evidence have formed the basis for this article. CONCLUSION The role of the nurse leaders is complex and demanding within the context of health care. Its value has been increasingly drawing the attention of national and international organizations. The nurse leader is performing tasks within rapidly shifting environments that require constant changes to best address the organizational goals but remain true to the values and perspectives envisioned by the nursing profession. Through the implementation of corresponding competency frameworks, the capacity and preparedness of nurse leaders can be cultivated ideally in a multidisciplinary context. IMPLICATIONS FOR NURSING PRACTICE Nurse leaders are increasingly assuming positions of authority across the structures of health care organizations. There is need to timely and appropriately increase the preparedness of nurse leaders to assume and sustain these challenging and dynamic roles.
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Affiliation(s)
- Andreas Charalambous
- Associate Professor, Oncology and Palliative Care, Cyprus University of Technology, Limassol, Cyprus; Adjunct Professor, University of Turku, Turku, Finland.
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Xiang J, Magier S, Gruen J, Welch M, Bilan V, Rodwin B, Norcott A, Merchant N. Building Resident Quality Improvement Knowledge and Engagement Through a Longitudinal, Mentored, and Experiential Learning-Based Quality Improvement Curriculum. MEDEDPORTAL : THE JOURNAL OF TEACHING AND LEARNING RESOURCES 2023; 19:11310. [PMID: 37081972 PMCID: PMC10110773 DOI: 10.15766/mep_2374-8265.11310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 01/08/2023] [Indexed: 05/03/2023]
Abstract
Introduction Quality improvement (QI) training is an essential component of resident medical education and a part of the ACGME core competencies. We present our residency's evidence-based QI curriculum, which outlines key components identified in the literature for successful QI education. Methods Our curriculum included a mandatory five-part longitudinal educational series during ambulatory education sessions for second-year residents. Modeled after the Institute for Healthcare Improvement model for improvement and taught by a chief resident, our curriculum introduced residents to key QI concepts through case-based, just-in-time didactics and applied experiential learning via concurrent resident-led longitudinal QI projects. Residents received structured, multilayer mentorship from a faculty mentor in their field of interest and the chief resident of quality and patient safety. Their work-in-progress projects were presented to faculty QI experts and institutional leadership for additional feedback and mentorship. Results Since 2016, a total of 234 internal medicine residents have completed our QI curriculum and developed 67 QI projects, which have been presented at various local, regional, and national conferences. In the 2 most recent academic years, Quality Improvement Knowledge Application Tool Revised (QIKAT-R) scores significantly increased from 4.6 precurriculum to 6.3 postcurriculum (p < .001). Discussion A longitudinal, experiential, and mentored QI curriculum teaches residents QI skill sets through incorporating mechanisms associated with successful educational initiatives and adult learning theory. Our QIKAT-R results and project output show that our curriculum is associated with improved trainee QI knowledge and systems-level improvements.
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Affiliation(s)
- Jenny Xiang
- Chief Resident, Department of Medicine, Yale School of Medicine and VA Connecticut Healthcare System
- Corresponding author:
| | - Samantha Magier
- Chief Resident, Department of Medicine, Yale School of Medicine and VA Connecticut Healthcare System
| | - Jadry Gruen
- Cardiology Fellow, Division of Cardiovascular Medicine, Penn Medicine
| | - Megan Welch
- Cardiology Fellow, Cardiology Division, Massachusetts General Hospital
| | - Victor Bilan
- Hematology/Oncology Fellow, Department of Medical Oncology, Sidney Kimmel Medical College at Thomas Jefferson University
| | - Benjamin Rodwin
- Assistant Professor, Department of Medicine, Yale School of Medicine and VA Connecticut Healthcare System
| | - Alexandra Norcott
- Clinical Instructor, Division of Geriatric and Palliative Medicine, Department of Internal Medicine, University of Michigan Medical School
| | - Naseema Merchant
- Assistant Professor, Department of Medicine, Yale School of Medicine and VA Connecticut Healthcare System
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Murray K, Fitzgerald E, Ali A, Crosby D, O'Reilly S, Lachman P. Developing future clinical leaders in patient safety: the Irish experience. BMJ LEADER 2022; 7:9-11. [PMID: 37013882 DOI: 10.1136/leader-2021-000462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 08/05/2022] [Indexed: 11/04/2022]
Abstract
IntroductionIt is 20 years since the Institute of Medicine advocated a national approach to improve care and patient safety. Patient safety infrastructure has greatly improved in certain countries. In Ireland, patient safety infrastructure is in ongoing development. To contribute to this, the Royal College of Physicians of Ireland/International Society for Quality in Healthcare Scholar in Residence Programme was launched in 2016. This programme aims to improve patient safety and develop a movement of future clinician leaders to drive improvements in patient safety and the quality of care.MethodsDoctors in postgraduate training complete a year-long immersive mentorship. This involves monthly group meetings with key patient safety opinion makers, one-on-one mentorship, leadership courses, conference attendance and presentations. Each scholar undertakes a quality improvement (QI) project.ResultsA QI project was associated with a decrease in caesarean section rates from 13.7% to 7.6% (p=0.0002) among women in spontaneous labour at term with a cephalic presentation. Other projects are ongoing.ConclusionMedical error, patient safety and QI must be addressed comprehensively at both undergraduate and postgraduate level. We believe the Irish mentorship programme will help to change the paradigm and improve patient safety.
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Affiliation(s)
- Kieran Murray
- Rheumatologist, University Hospital Limerick, Dooradoyle, Limerick, Ireland
| | | | - Ahmeda Ali
- General Practitioner, Irish College of General Practitioners, Dublin, Ireland
| | - David Crosby
- Obstetrician, National Maternity Hospital, Dublin 2, Dublin, Ireland
| | - Susanne O'Reilly
- Gastroenterology, St Vincent's Healthcare Group Ltd, Dublin 4, Dublin, Ireland
| | - Peter Lachman
- Lead Faculty Quality Improvement Programme, Royal College of Physicians of Ireland, Dublin, Ireland
- International Society for Quality in Health Care, Dublin, Ireland
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Brugman IM, Visser A, Maaskant JM, Geerlings SE, Eskes AM. The Evaluation of an Interprofessional QI Program: A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10087. [PMID: 36011718 PMCID: PMC9408409 DOI: 10.3390/ijerph191610087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 08/10/2022] [Accepted: 08/12/2022] [Indexed: 06/15/2023]
Abstract
Background: Quality Improvement (QI) is the key for every healthcare organization. QI programs may help healthcare professionals to develop the needed skills for interprofessional collaboration through interprofessional education. Furthermore, the role of diversity in QI teams is not yet fully understood. This evaluation study aimed to obtain in-depth insights into the expectations and experiences of different stakeholders of a hospital-wide interprofessional QI program. Methods: This qualitative study builds upon 20 semi-structured interviews with participants and two focus groups with the coaches and program advisory board members of this QI program. Data were coded and analyzed using thematic analysis. Results: Three themes emerged from the analysis: "interprofessional education", "networking" and "motivation: presence with pitfalls". Working within interprofessional project groups was valuable, because participants with different experiences and skills helped to move the QI project forward. It was simultaneously challenging because IPE was new and revealed problems with hierarchy, communication and planning. Networking was also deemed valuable, but a shared space to keep in contact after finalizing the program was missing. The participants were highly motivated to finish their QI project, but they underestimated the challenges. Conclusions: A hospital-wide QI program must explicitly pay attention to interprofessional collaboration and networking. Leaders of the QI program must cherish the motivation of the participants and make sure that the QI projects are realistic.
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Affiliation(s)
- Ilja M. Brugman
- Department of Surgery, Amsterdam UMC, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands
| | - Annelies Visser
- Department of Surgery, Amsterdam UMC, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands
| | - Jolanda M. Maaskant
- Emma Children’s Hospital, Amsterdam UMC, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands
- Department of Epidemiology and Data Science, Amsterdam UMC, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands
| | - Suzanne E. Geerlings
- Department of Internal Medicine, Infection, Immunity and Infectious Diseases, Amsterdam UMC, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, 1105 AZ Amsterdam, The Netherlands
| | - Anne M. Eskes
- Department of Surgery, Amsterdam UMC, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands
- ACHIEVE, Centre of Applied Research, Faculty of Health, Amsterdam University of Applied Sciences, 1105 BD Amsterdam, The Netherlands
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Zumstein-Shaha M, Grace PJ. Competency frameworks, nursing perspectives, and interdisciplinary collaborations for good patient care: Delineating boundaries. Nurs Philos 2022; 24:e12402. [PMID: 35761762 PMCID: PMC10078421 DOI: 10.1111/nup.12402] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 04/29/2022] [Accepted: 06/17/2022] [Indexed: 11/29/2022]
Abstract
To enhance patient care in the inevitable conditions of complexity that exist in contemporary healthcare, collaboration among healthcare professions is critical. While each profession necessarily has its own primary focus and perspective on the nature of human healthcare needs, these alone are insufficient for meeting the complex needs of patients (and potential patients). Persons are inevitably contextual entities, inseparable from their environments, and are subject to institutional and social barriers that can detract from good care or from accessing healthcare. These are some of the reasons behind current movements to develop competency frameworks that can enhance cross-disciplinary communication and collaboration. No single profession can claim the big picture. Effective teamwork is essential and requires members of diverse professions to understand the nature of each other's knowledge, skills, roles, perspectives, and perceived responsibilities so that they are optimally utilized on behalf of patients and their families. Interdisciplinary approaches to care permit different aspects of a person's needs to be addressed seamlessly and facilitate the removal of obstacles by engaging the range of resources exemplified by the different professions. Additionally, collaborative efforts are needed to influence policy changes on behalf of individual and social good and to address root causes of poor health especially as these impact society's most vulnerable. Here, we explore both the benefits and the risks of an uncritical acceptance of competency frameworks as a way to enhance interdisciplinary communication. We highlight the importance of anchoring proposed competency domains in the reason for being of a given profession and exemplify one way this has been accomplished for advanced practice nursing. Additionally, we argue that having this mooring, permits integration of the various competencies that both enhances professional moral agency and facilitates interdisciplinary collaboration to further the mutual goals of the healthcare professions on behalf of quality patient care.
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Affiliation(s)
- Maya Zumstein-Shaha
- Department of Health, Master of Science in Nursing Program, Adjunct Head of Program, Bern University of Applied Sciences, Bern, Switzerland.,Department of Nursing, Faculty for Health, University of Witten/Herdecke, Witten, Germany
| | - Pamela J Grace
- Boston College, William F. Connell School of Nursing, Boston, Massachusetts, USA
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Kristobak BM, Snider JA. Problem-Based Learning Discussion to Introduce Quality Improvement to Residents in the Perioperative Setting. MEDEDPORTAL : THE JOURNAL OF TEACHING AND LEARNING RESOURCES 2021; 17:11198. [PMID: 34901417 PMCID: PMC8627916 DOI: 10.15766/mep_2374-8265.11198] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 08/31/2021] [Indexed: 06/14/2023]
Abstract
INTRODUCTION Quality improvement (QI) is a growing and critical part of perioperative medical practice. However, there are few examples of educational tools to introduce new learners from anesthesiology to QI. This may contribute to a lack of enthusiasm to learn about and apply these concepts. METHODS This problem-based learning discussion (PBLD) was designed to teach anesthesiology residents about QI in a way allowing for the application of core concepts in a group setting. We created this PBLD using available literature on QI in the perioperative setting. Basic concepts and terminology necessary for new learners to communicate about QI were specifically addressed. Feedback from staff anesthesiologists and resident participants in the PBLD was used to tailor it to the needs of the target learners and to reach the educational objectives. RESULTS We delivered this PBLD in two separate learning sessions both to board-certified anesthesiologists (N = 10) and to resident anesthesiologists (N = 19) at our institution. The exercise was reviewed anonymously, and qualitative feedback was used to improve updated versions. Respondents felt that the PBLD would be improved by avoiding jargon-based humor, considering the systemic implications of QI, and limiting the overall length of the learning tool. The PBLD has been adopted as a starting point for discussions about QI in our training program. DISCUSSION We feel this PBLD can introduce new learners to the learning objectives. This tool has provided an alternative to lectures or computer-based modules for teaching QI.
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Affiliation(s)
- Benjamin M. Kristobak
- Staff Anesthesiologist, Walter Reed National Military Medical Center; Assistant Professor, Department of Anesthesiology, Uniformed Services University of the Health Sciences F. Edward Hébert School of Medicine; Associate Program Director, National Capital Consortium Residency in Anesthesiology
| | - Jesse A. Snider
- Resident, National Capital Consortium Residency in Anesthesiology
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Jacobs ML, Mlinac ME. Healthcare Quality Improvement Competency: A Clinical and Training Imperative for Geropsychology. J Clin Psychol Med Settings 2021; 28:897-908. [PMID: 34596823 DOI: 10.1007/s10880-021-09824-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/08/2021] [Indexed: 11/26/2022]
Abstract
Quality improvement (QI) work is increasingly necessary to ensure healthcare is delivered safely, efficiently, and equitably. As geropsychologists play an increasingly vital role in healthcare service delivery for older adults, it is imperative that they develop professional competence in QI, yet there is little formal QI training aimed at geropsychologists or to graduate students pursuing geropsychology. This article aims to elucidate the importance of QI education and training in geropsychology. In line with the Pikes Peak model for training in professional geropsychology, we outline QI knowledge and skills competencies for geropsychology training and suggest a rubric for integrating QI education into academic and clinical training from graduate school to professional practice. We provide recommended readings that geropsychology educators can read to become familiar with QI or use as part of a syllabus. Finally, we offer some recommendations for how current and future geropsychologists can be leaders in quality improvement work.
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Affiliation(s)
- M Lindsey Jacobs
- Research & Development Service, Tuscaloosa VA Medical Center, 3701 Loop Road, Tuscaloosa, AL, 35404, USA.
- Department of Psychology, The University of Alabama, Tuscaloosa, AL, USA.
| | - Michelle E Mlinac
- VA Boston Healthcare System, Jamaica Plain, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
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