“We need quality improvement now more than ever,” Lori DiPrete Brown, director of the Quality Improvement Leadership Institute, told 2017 closing symposium. for the 2017 Quality Improvement (QI) Leadership Institute at the University of Wisconsin-Madison. “Together, we can make life better for those we care for and strengthen our ability to be advocates and architects of system change.”
More than 30 health leaders from a nine countries and Wisconsin joined health science students and medical residents July 24 to 29, engaging with UW health experts, sharing leadership lessons and learning how to apply quality improvement principles to challenges they face. At the closing symposium, they presented concrete plans designed to improve health and well-being in their hospitals, clinics and communities.
DiPrete Brown, an associate director at the UW-Madison Global Health Institute (GHI), underscored the importance of leaders taking actions on an important problem within their sphere of influence. “Addressing problems effectively at the point of care is important for individuals and communities in real time and moves the frontier of what is possible for the overall system,” she said.
“The opportunity to network and learn from each other’s struggles and successes is what makes this program so impactful.”—Sweta Shrestha, assistant QI director
Now in its seventh year, the annual QI Leadership Institute, hosted by the GHI, has included participants from more than 20 countries and Wisconsin. These health leaders learn how to define, implement, measure and sustain quality in low-resource settings. The Institute is built on the importance of leadership, teamwork and collaboration across disciplines. Each year, UW-Madison’s global health leaders also share their experience on a variety of topics, from graduate medical education, health in all policies and climate change to vaccinations and palliative care.
This year’s projects again spanned the globe, from India to Mexico, Ethiopia to Wisconsin. Participants return home ready to bring in collaborators and begin projects that range from improving hand hygiene to better managing medical equipment to providing support for people living with mental illness and substance use disorders. One project will reduce the length of stay and cost to patients with tibia fractures in Bomet, Kenya. Another will reduce child mortality in Mangochi Hospital, Malawi. QI will be used to improve education in Malawi and for to improve children’s diets in Bhopal, India.
“These participants and projects exemplify the breadth and reach of QI efforts,” said Sweta Shrestha, GHI’s assistant director for education and assistant director of the QI Institute. “The core principles of QI, tools- and systems-focused approaches for improvement and organizational cultural change, highlight the opportunities and potential for dramatic changes in health and wellness.”
These were among the projects crafted during QI week:
Ghulam Mustafa, an associate professor of pediatrics in Pakistan who participated in the American Academy of Pediatrics ICATCH grants program, goes home with a plan to reduce the use of antibiotics for uncomplicated bronchiolitis— usually a viral disease—by 90 percent at Nishtar Medical University in Multan. The pediatrics emergency room sees 200 to 250 patients a day, so triage is difficult and parents often request IV antibiotics for their children. His plan rests on new training for medical residents who work with families, with an eye to saving millions of dollars on unneeded medications, sparing children IV lines and reducing the potential of antibiotic resistance.
Lailigh Castro Ortiz, a physician and director of Medicine at the University of Guadalajara, Mexico, tackled obesity at her university where half of students get no exercise and many eat outside of their homes. She hopes to design spaces that encourage activity and limit what’s sold on campus, including eliminating soda and junk food and serving eggs from local farmers for breakfast. “Obesity is a predominant problem in our society,” she said. “Its treatment should cover the psychological, nutritional, social, cultural and physiological aspect to be able to succeed.”
- Sabasian Ssempijja, a Milwaukee psychologist, Makumbi Majella, a clinical psychologist in Uganda, and Fred Coleman, a Madison, Wisconsin, psychiatrist, used QI week to develop a plan to reduce alcohol and drug abuse in Uganda. The Ministry of Health, the Federation of Employees at a major manufacturer and the Mayor of Entebbe all looked for help with a growing drug and alcohol problem. Ugandan families who once lived close to each other are now dispersed so support systems are weakened. Others have been exposed to war and violence.
“Alcohol is culturally acceptable in our country,” Majella said. “Alcohol is available and cheap (as little as 10-cents in U.S. dollars) and attractively packaged,” he says. The team leaves with a plan to provide screening and care or referral for up to 80 percent of patients at three clinical sites and host community meetings to increase awareness of the problem.
- Amy Bintliff, a high school teacher and doctoral student, looked for ways to reduce teacher burnout and attrition in the face of increasing violence in schools and their work with traumatized students. “If you look at U.S. urban schools, you see teachers dealing with PTSD (post-traumatic stress disorder), and few are doing anything about it,” she said. “Teachers are there for their students … so their own well-being goes to the bottom. There’s a huge need for trauma help for teachers in our country.” Bintliff’s strategy includes in-house support groups and training in how to identify secondary trauma.
- Carrie Simon and Jenna Ramaker work with a new comprehensive community services program in Dane Country that has attracted 600 clients in its first two years. They will use QI to develop care and referral guidelines and evaluation tools. Their goal is to assure quality and efficiency as they collaborate with 75 agencies that provide care.
“It is a privilege to host this stellar group of participants from Wisconsin and around the world at UW- Madison to share, learn and grow,” Shrestha said. “The opportunity to network and learn from each other’s struggles and successes is what makes this program so impactful. We look forward to continuing these conversations and projects started this week and providing mentorship and support as participants implement QI into their work.”
See more photos from the 2017 QI Leadership Symposium.
By Ann Grauvogl/ August 14, 2017