Both the public and our profession acknowledge that quality and safety efforts are falling short, and many hospitals and healthcare systems are seeking rapid improvements in patient care. Those of us in academic medicine realize that residents play an important role in patient care at teaching institutions; however, residents are generally not visible in safety and quality efforts. The AIAMC recognized that resident quality improvement efforts – shared across multiple programs and systems – had the potential to improve care much more quickly and effectively.
The Alliance of Independent Academic Medical Centers was founded in 1989 as a national network of large academic medical centers. Membership in the association is unique in that AIAMC members are affiliated with medical schools but are independent of medical school ownership or governance. Approximately 80 major medical centers and health systems across the United States are members, representing more than 750 senior academic leaders.
In early 2007, the Alliance of Independent Academic Medical Centers (AIAMC) launched Improving Patient Care through GME: A National Initiative of Independent Academic Medical Centers. The National Initiative (NI) featured five meetings over the course of 18 months which served as touchstones for ongoing quality improvement in 19 AIAMC participating organizations. These meetings, as well as the monthly collaborative calls held in-between, provided structure, discussion and networking opportunities around specific quality improvement initiatives. This 18-month "NI I" was supported by a grant from the foundation of HealthPartners Institute for Medical Education, an AIAMC member institution located in Minneapolis, Minnesota.
As a result of these efforts, we developed initial findings that demonstrated the efficacy of integrating GME into patient safety and quality improvement initiatives. These findings were organized into a series of articles that were published in the December 2009 issue of Academic Medicine.
In 2009, we launched the National Initiative II and expanded participation to 35 AIAMC-member teaching hospitals from Seattle to Maine. Each participating hospital developed a quality improvement team led by a resident or faculty member. These teams met on-site four times and participated in monthly conference calls over an 18-month period. Quality improvement projects focused upon one of the following areas: Communication, Hand Offs, Infection Control, Readmissions and Transitions of Care.
Results from NI II were published in a variety of publications, including the February 2011 issue of the AAMC Reporter, and in the May/June 2012 special supplement issue of the American Journal of Medical Quality.
NI III, launched in 2011 with 35 teams, built on the strengths of the first two phases of the AIAMC National Initiative, and moved beyond direct support of local quality improvement teams to the development of teaching leadership and changing organizational culture to support quality improvement initiatives. Graduate medical education and continuing medical education were emphasized as platforms for improving patient care. The focus of NI III was faculty/leadership development. We recognized that part of our responsibility as medical educators was to train the next generation of practicing physicians; thus, residents must be considered as junior faculty and were integral in this effort.
Results from NI III were published in a variety of publications, including the Spring 2014 issue of The Ochsner Journal and the Journal of the American College of Surgeons.
NI IV: Achieving Mastery of CLER, launched in 2013 with 34 AIAMC-member and – for the first time – non-member teams, focused on navigating the ACGME’s Clinical Learning Environment Review (CLER) program. The CLER program was designed to evaluate the level of institutional responsibility for the quality and safety of the learning and patient care environment, and NI IV provided teams the training and guidance necessary that identified strengths and weaknesses across the six focus areas and significantly and measurably advanced the institutional level of preparedness.
Results from NI IV were published in numerous publications, including the Journal of Graduate Medical Education and The Ochsner Journal, the official publication of the AIAMC National Initiatives.
National Initiative V: Improving Community Health and Health Equity through Medical Education launched in the fall of 2015 with 29 AIAMC-member teams participating and focused on navigating the disparities component of the ACGME’s Clinical Learning Environment program. Four on-site learning sessions addressed understanding and engaging with institutional leaders in the Community Health Needs Assessments; GME education in improving health equity, cultural competency and community engagement; and how to better engage the C-Suite. The Initiative concluded in March 2017.
Various writing teams are currently preparing manuscripts for publication.
National Initiative VI: Stimulating a Culture of Well-Being in the Clinical Learning Environment launched in 2017 with 35 participating teams from Seattle to Maine. The Initiative is 18 months in length and features four on-site meetings and monthly teleconferences or webinars. Monthly team cohort groups will be structured by themes based on focus areas identified in the applications, with best practices from all teleconference groups shared at the on-site meetings. On-site learning sessions topics include research on well-being; barriers, gaps and stigma encountered in seeking well-being resources; leadership, sustainability and culture required to support well-being; and C-Suite engagement.
The AIAMC National Initiative (NI) is the only national and multi-institutional collaborative of its kind
in which residents lead multidisciplinary teams in quality improvement projects aligned to their
institution’s strategic goals. Sixty-four hospitals and health systems and more than 1,000 individuals
have participated in the AIAMC National Initiatives since 2007 driving change that has resulted in meaningful and sustainable outcomes improving the quality and safety of patient care