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Second Opinion

Learn about policy issues important to medical schools and teaching hospitals, with Executive Vice President Atul Grover, M.D., Ph.D.

The Social Missions of Medical Schools and Teaching Hospitals at Work

March 31, 2011

This week, the AAMC launched Best Practices for Better Care (BPBC), an unprecedented commitment by medical schools, teaching hospitals, faculty physicians, and researchers to advance quality and safety in America's health care. More than 200 institutions have already signed on to the campaign, ensuring that current and future health professionals have the tools they need to improve care and to be leaders in quality and safety in their practices and communities.

Through BPBC, teaching hospitals and faculty physicians in participating institutions also are committed to making today's care for hospital patients safer and more effective. They've targeted three areas where practices pioneered in teaching hospitals can be expanded to benefit over 10 percent of patients admitted to hospitals.

First, surgical checklists will be required in operating rooms to improve both communication among the surgical team and outcomes for patients. Checklists have been around for years, but putting them into routine use can be difficult. Though it may seem simple just to check the boxes, using tools successfully requires real changes in the way that surgeons communicate with anesthesiologists, nurses, patients, and others in the operating room. Checklists can help doctors ask the right questions and ensure that conversations between the operating room team occur before, during, and after surgery in a way that improves patient safety.

Second, all intensive care units will implement proven techniques to reduce infections in "central lines," the large IVs that are often necessary for administering medications to some of the sickest patients or for procedures such as dialysis. Patients in teaching hospitals are often more ill and at higher risk for infection, even when central line insertions are performed by the most skilled professionals. As the CDC recently reported, using the right equipment and materials and other proven techniques can greatly reduce that risk. BPBC hospitals will report how they are doing in implementing these changes and how these new procedures affect infection rates.

Third, teaching hospitals will institute changes to improve how well patients do once they are discharged and back in their homes or other community-based settings. With an aging and increasingly ill population, and with advances in outpatient care, patients are leaving the hospital with more medications and more chronic conditions. This reality coupled with a worsening shortage of physicians means getting appropriate follow-up care can be challenging for even the best-educated patients with access to adequate resources. BPBC hospitals and physicians will follow-up with high-risk patients within 72 hours of discharge to help them get back to their own doctors and make sure that these patients can follow their discharge instructions.

BPBC medical schools and teaching hospitals will make sure that students and resident physicians are engaged in the patient safety measures that are part of the campaign commitment. Most medical schools already have formal quality curricula; however, creating a learning environment in which physicians can be trained to constantly ask how they can make even the best care better can be tough when new physicians also are trying to master the magnitude of required scientific and medical information. Medical schools and residency programs are trying to learn from each other how best to create educational programs that teach physicians to improve quality and safety throughout their careers as they go on to practice in communities all across the country.

Medical schools and teaching hospitals are hubs of innovation, training the doctors; discovering the cures; and providing trauma, burn, transplant, and other specialized services every day. Through Best Practices for Better Care, these institutions are raising their standards of care, committing to evaluate what works to make health care better for patients, and sharing that information with others in the medical community. Teams of clinicians and researchers also will ensure that the time from discovery to changing the practice of medicine can be as efficient as possible.

At the AAMC, we're working to help medical schools and teaching hospitals meet these goals as they continue to train the best doctors in the world.

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About the Author

Atul Grover, MD, PhD AAMC Executive Vice President

Atul Grover, MD, PhD
AAMC Executive Vice President

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@AtulGroverMD



For More Information

Peters Willson
Sr. Specialist, Policy and Constituency Issues
Telephone: 202-862-6029
Email: pwillson@aamc.org