The Miller-Coulson Academy of Clinical Excellence at Johns Hopkins Bayview Medical CenterPresentation Transcript
The Miller-Coulson Academy of Clinical Excellence at Johns Hopkins Bayview Medical Center Scott Wright, MD, Steven Kravet, MD, MBA, Colleen Christmas, MD, Samuel Durso, MD, Kathleen Burkhart, MPA, David Hellmann, MD Rationale for the Academy Background Measurement —The Clinical Portfolio
To demonstrate, particularly to trainees and junior faculty, that patient care is valued in academic medicine.
To advocate for the busy academic clinician.
To generate new knowledge and advance the understanding of related content areas through research.
To advance metrics to measure clinical performance at Hopkins.
To create a community of collaboration (a ‘Think Tank’) around excellence in patient care; leading to educational and clinical programs.
To highlight excellence in patient care as the goal that is to be aspired to – resulting in higher quality care delivery.
To improve clinician morale – with hopes for impact upon retention and recruitment.
Academic medical centers are committed to the tripartite missions of research, education, and patient care. It is not known how to recognize clinicians who spend a majority of their time and excel in caring for patients.
The definition was operationalized into a measurement tool, the ‘clinical portfolio’; a 30+ page document assembled by those nominated by peers for membership in the Academy.
Select components of the portfolio:
Clinical Draw to Institution
- Proportion of patients coming from >25 miles & out of state
Input from Referees (patients, physician-colleagues, nurses, & trainees)
Quality Improvement Initiatives
Interface with Researchers
Awards for Clinical Accomplishment
The portfolios were evaluated and scored by an ‘external review board’ (akin to a study section).
Our experiences have found the clinical portfolio to be discriminative and reliable. There was consensus among the reviewers, and with the internal committee, about those to be accepted for membership in the Academy (this cycle: 9 of the 18 nominees were accepted to become members).
Defining Excellence in Patient Care in Academia Informed by Meetings with institutional leaders
Promotion Committee Chairs
Meetings with national leaders
Professors from top academic medical centers
Representatives from ABIM, ACP, NBME, AMA
Systematic review of the medical literature Qualitative studies Quantitative studies Resultant definition: Achieving a level of mastery in the following 6 areas as they relate to patient care: i. communication & interpersonal skills ii. professionalism and humanism iii. diagnostic acumen iv. skillful negotiation of the healthcare system v. knowledge vi. scholarly approach to clinical practice, and Exhibiting a passion for patient care, and Explicitly modeling this mastery to medical trainees. Conclusions Academy Members and Programs
The scholarly approach and rigor of the work leading up to the launch of the Academy has influenced the tremendous support from stakeholders, particularly institutional leadership.
The members of this ‘working’ Academy are committed to the primacy of patient care and to influencing institutional culture.
Annual ‘Excellence in Patient Care’ Symposium
Clinical Excellence Blog
Research studies ongoing
‘Unknown Case Vignette’ Medical Grand Rounds with Academy members as discussants
‘Excellence in Patient Care’ curriculum
* We are indebted to the Miller and Coulson families for their generosity, and to the Johns Hopkins Center for Innovative Medicine for their support.