New York Medical College

NYMC Examines:

Reducing Medical Errors

Who cares about quality improvement in health care? Is it just hospital administrators, the “bean-counters,” the Joint Commission?

Three Schools, Three Perspecitves


Faculty develop an innovative program to reduce medical errors

It should matter a great deal to every individual who works in a hospital, or plans to, but that idealistic goal has been somewhat elusive. Now an innovative, multi-pronged approach, developed by the Department of Medicine and singled out for excellence by a national accrediting entity, has begun chipping away at a persistent and pervasive problem, winning new hearts and minds to the cause of quality improvement and patient safety in hospitals where it is implemented.

In 2005, the American Council for Graduate Medical Education invited the nation’s internal medicine residency programs to submit applications for the Educational Innovation Project (EIP), a novel pilot program that encouraged residency directors to find new ways to integrate quality improvement and educational outcomes in patient care into their curriculum. Among the 17 sponsored residency programs selected for participation was the New York Medical College internal medicine residency program based at Westchester Medical Center.

The residency program administrators knew just the area to target for improvement: the “hand-off” -- the transfer of patient information between primary and covering teams in hospitals during shift changes. Without a clear cut system of checks and balances, dangerous errors and oversights can easily occur when a patient’s care is turned over to a different doctor.

The team began its work after the medical center’s administration obtained a state-of-the-art computerized sign-out program called the Patient Documentation Transfer System. The program already had a reputation for successfully standardizing the flow of patient information during shift changes. But these innovators didn’t stop there: they introduced unique patient safety features that made house staff and supervisors more accountable, honing the communications tool to even greater precision and effectiveness.

They also developed an administrative internship of sorts, thus ensuring that house staff become fully immersed in the EIP-inspired quality of care curriculum. By rotating residents through the hospital’s departments as they complete patient quality projects with pharmacists, case managers, risk managers, occupational health staff and others, house officers gained a deeper understanding of how all units function together to produce the highest quality of care. As a result, several EIP project participants are on their way to becoming authorities on the subject. As for the hand-offs? They are showing a marked improvement.

The College continues to be the only medicine training program in New York State to participate in the EIP, which serves as a model training program for the nation’s residency programs. Faculty members published a paper on the hand-off (or “sign-out”) program in the March 2011 Journal of Graduate Medical Education.

A Multidisciplinary Approach for Teaching Systems-Based Practice to Internal Medicine Residents
Christopher Nabors, Stephen J Peterson, Roger Weems, Leanne Forman, Arif Mumtaz, Randy Goldberg, Kausik Kar, Joseph A Borges, Ida Doctor, Orpha Lubben, Nisha Pherwani and William H Frishman. Journal of Graduate Medical Education, Mar 2011, Vol. 3, No. 1, pp. 75-80

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Page updated: July 17, 2012