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Chief Resident in Quality and Patient Safety helping to improve care at VA

December 07, 2016

Representatives of the VA Connecticut Healthcare System in West Haven traveled to Boston on November 30 to present on a post-residency fellowship that works to improve the quality of care and safety of patients at the VA.

The VA Chief Residents in Quality and Patient Safety (CRQS) is a federally funded, non-accredited, post-residency position that has been based at the West Haven VA for three years.

The Chief Resident – this year’s chief is David Moore, MD, PhD – works on a variety of quality improvement and patient safety projects to refine the system of care of veterans

All CRQS sites – there are 87 positions at 57 VA Medical Centers across the country – participate in a standardized national curriculum. The sites send their chiefs to a “CRQS Boot Camp” put on by a national patient safety council. Chiefs are taught advanced quality improvement and patient safety concepts.

The chiefs also engage in monthly two-way interactive video-teleconferences with experts in the field, and are supervised by an on-site mentor at the VA.

“They learn, they teach, they do clinical work, they do research. It’s a really exciting program,” said Louis Trevisan, MD, Associate Professor of Psychiatry at Yale and CRQS mentor who wrote the West Haven VA’s grant. “It’s a very innovative program that the VA has come up with. It has paid lots of dividends. It improves care to veterans. That’s what it’s really all about.”

The November 30 presentation was to the VA National Academic Affiliations Council, which provides a forum for planning and coordination between VA hospitals and medical schools and universities.

Trevisan, Moore and Linda Godleski, Professor of Psychiatry and Associate Chief of Staff for Education at VA Connecticut, represented West Haven at the meeting, and presented the program to the council.

“It was very well received,” Trevisan said. “We were very happy to have been asked to participate.”

Among the goals of the program is to improve institutional performance and patient safety through changes in the patient safety culture. The chief resident examines medication prescribing patterns, “hand-offs” between medicine and psychiatry, and does problem solving through root cause analysis.

“Ultimately it benefits the veterans because we are improving the systems of care,” said Trevisan, adding the intention is not to place blame on people when something goes wrong.

“It’s to figure out how to improve the system,” he said. “This is a way to try and change a culture, too.”

The chief resident also teaches performance improvements and patient safety in the Yale Department of Psychiatry’s Medical Education Program. “Part of their job is to help younger residents come up with individual quality improvement projects,” Trevisan said.

Last year, the West Haven VA hosted a fourth-year resident from the Mayo Clinic for a one-month rotation. The student wrote a paper about the experience.

The visit and establishment of the CRQS position in West Haven is part of a larger effort by the VA to draw qualified candidates into the hospital system.

“We get to look at folks who have potential administrative abilities … to potentially recruit into the VA and Yale,” Trevisan said. “It’s a growing field in mental health.”

Submitted by Christopher Gardner on December 07, 2016