Needed leaders and leaders’ needs: The creation of a quality improvement and clinical operations pathway for heme/onc fellows.

Abstract

e21008 Background: The Accreditation Council for Graduate Medical Education requires training programs to provide education on quality improvement and patient safety (QIPS). Concurrently, the complex needs of a growing cancer population have created a workforce demand for clinical operations- and QIPS- focused physicians poised to implement innovative models of health care delivery. Professional development pathways supporting growth of such careers are uncommon. At our institution, we created a one-year track for hematology/oncology and other subspecialty fellows seeking careers as clinical operations and QIPS leaders. We performed two complementary needs assessments to define the scope of the need and identify best practices to inform track development. Methods: Needs assessments were based upon two separate reviews. 1) We evaluated recruitment websites for National Cancer Institute (NCI)-designated institutions with adult hematology/oncology fellowships to assess the proportion of programs offering QIPS opportunities and specialized training pathways. Results are presented as proportions with 95% confidence intervals (CI). 2) Given lack of information surrounding pathway details, a scoping literature review was then performed to extract key elements of analogous QIPS tracks. We identified PubMed indexed articles using key terms “quality and safety,” “training” and “track,” and included articles in English if they highlighted the structure of specialized QIPS pathways. Results: At 72 NCI sites, 66 (92%) fellowship training programs were identified. All programs had recruitment websites. Of the 66 fellowship programs, 34 (51.5%, CI 38.8-64.0) highlighted their QIPS opportunities, but only 5 (7.6%, CI 2.5-16.8) identified QIPS training tracks. In comparison, all programs promoted research opportunities including specific training tracks. Subsequent literature review revealed 14 articles of which 5 were included per pre-specified criteria. All pathways included a core curriculum (n=5; 100%) provided as an intensive course (n=3; 60%) and/or longitudinal training (n=4; 80%) and participation in a scholarly project (n=5; 100%). Other elements included teaching (n=3; 60%) and leadership training (n=4; 80%) (Table 1). Conclusions: QIPS training pathways for fellows at NCI cancer centers are uncommon. Key structural elements for goal-concordant professional pathways to develop QIPS leaders include: a core curriculum, conduct of a scholarly project, leadership training, and teaching. Core elements of QIPS tracks. Training Level Length (years) QI Project Teaching Leadership Training Vinci, Am J Med Qual , 2014 UME 4 Yes No Yes Butcher, Am J Med Qual , 2019 GME 1 Yes Yes No Patel, Acad Med , 2015. GME 2 Yes No Yes Baxley, Acad Med , 2016 All Levels 1 Yes Yes Yes Snyder, Acad Radiol , 2016 GME 3-4 Yes Yes Yes GME: Graduate Medical Education; UME: Undergraduate Medical Education.