Programs within the Center

VA National Quality Scholars Fellowship Program (VAQS)

VA National Quality Scholars Fellowship (VAQS) is a two-year program offered at six sites throughout the United States. The hub site is located at TDI. The VAQS Fellowship prepares the Fellows in the methods of health care improvement and ongoing improvement of health care services for veterans by innovation, research, teaching and the development of new knowledge. The Program began in 1998 and focused on preparation of infrastructure and curriculum as well as recruitment of the first cohort of fellows. The Senior Scholars established a clearly identifiable program that encouraged collaboration among the administrative leadership, e.g., the facility Director, VISN Director, the VISN Quality Management Officer, and deans and department chairs at the affiliated medical school in such areas as public health, public administration, business administration, or health administration. In addition, they worked closely with clinical leadership, including the chief of staff, clinical service manager, and appropriate clinical service chiefs, to ensure a program that would contribute value to patient care. The VAQS Program enrolled its first physician fellows in 1999.

Today the program continues to grow with the addition of pre- and post-doctoral nurses as fellows in the revised interprofessional fellowship curriculum.
For more information on the VAQS program
http://www.vaqs.org/

Dartmouth-Hitchcock Leadership Preventive Medicine Residency Program (DHLPMR)

The Dartmouth-Hitchcock Leadership Preventive Medicine Residency (DHLPMR) is a two-year program completed in conjunction with a D-H clinical residency or fellowship or the Family Practice residency at Concord Hospital. The program is offered jointly by TDI and DHMC and is the first of its kind in the nation. Residents earn the MPH at TDI and engage in the opportunity to translate this knowledge into improving a process of care for a subpopulation of patients.

Twenty-one residents have completed the program since 2003, when the first resident entered the program. A number have stayed on as faculty as DHMC and Concord, and others have successfully moved into positions around the country where they will continue to improve clinical care.
For more information on the DHLPMR program
http://www.dhmc.org/webpage.cfm?site_id=2&org_id=120&gsec_id=0&sec_id=0&item_id=3293

Resources within the Center

Clinical Microsystems

A microsystem in health care delivery can be defined as a small group of people who work together on a regular basis to provide care to discrete subpopulations including the patients. It has clinical and business aims, linked processes, shared information environment and produces performance outcomes. They evolve over time and are (often) embedded in larger organizations. As a type of complex adaptive system, they must: (1) do the work, (2) meet staff needs, (3) maintain themselves as a clinical unit.

Clinical microsystems are the front-line units that provide most health care to most people. They are the places where patients, families and care teams meet. Microsystems also include support staff, processes, technology and recurring patterns of information, behavior and results. Central to every clinical microsystem is the patient.
Please visit: http://dms.dartmouth.edu/cms/

SQUIRE Guidelines

The Standards for QUality Improvement Reporting Excellence (SQUIRE) Guidelines are a very indepth guide to help authors write excellent, usable articles about quality improvement in healthcare so that findings may be easily discovered and widely disseminated.

Improvement efforts focus primarily on making care better at local sites, rather than on generating new, generalizable scientific knowledge. Despite its local focus, improvement frequently generates important new generalizable knowledge about systems of care and about how best to change those systems. Whether improvement interventions are small or large, simple or complex, the SQUIRE guidelines provide an explicit framework for sharing the knowledge acquired by examining those interventions closely, carefully, and in detail.

The SQUIRE website supports high quality writing about improvement through listing available resources and discussions about the writing process.
Please visit: http://squire-statement.org/

Faculty and Student Development

Summer Symposium

Affectionately known as 'summer camp', the invitational week-long summer symposium is based on the underlying theme of continual improvement in health care. For 15 years, the Center for Leadership & Improvement (formerly known as Healthcare Improvement Leadership Development), along with the Institute for Healthcare Improvement (IHI), annually hosted the camp. As with all things, change must happen to continue growth and vitalization. The host for the 16th year of summer camp is the University of Missouri-Columbia with valued support from the Center for Leadership and Improvement, TDI.

The aim of the symposium is to create a learning environment where participants can advance their understanding of the substance and implications of "knowledge for improvement;" examine the theoretical, methodological, and practice linkages between health profession disciplines (subject matter knowledge) and quality improvement knowledge; and to develop frameworks, research agendas, curriculum innovations and other tools for integrating, disciplinary and subject knowledge with quality improvement knowledge.

Graduate Courses

The faculty within the Center for Leadership and Improvement teach a variety of the masters courses within the TDI Center for Education.

Fall term: ECS 117: The Continual Improvement of Health Care: An Overview Class Aim: Offer participants an opportunity to discover and preview the knowledge, methods and skills necessary to participate in, and help make sense of the continual improvement and innovation of health care.

Winter term: ECS 126: Statistical Measurement and Analysis for Quality Improvement Class Aim: To gain a deep understanding for the development of the science of studying and measuring variation in daily work and the application of that work to the improvement of patient care.

Spring term: ECS 124: Continually Improving the Health and Value of Health Care for a Population of Patients: The Design and Improvement of Clinical Microsystems Class Aim: To understand and participate in the design and improvement of a clinical microsystem.