Residency Education Advancing and Changing Healthcare REACH

1. Residency Education Advancing and Changing HealthcareREACH Indiana University Educational Innovations Project

2. Indiana University School of Medicine Indiana�s REACH Residency Education Advancing & Changing Healthcare Three main initiatives Institutional support Planning Process Team Effort

3. Indiana University School of Medicine A Collaborative Effort IUSM Leadership Dean and Chairman Team of Program Directors Contributors and Consultants Chiefs, Residents, Faculty Stakeholders Clarian Health Partners, Wishard, VA, Regenstrief, IUMG-PC, GME office

4. Indiana University School of Medicine Bridging the Competencies and the 21st Century Healthcare System

5. Indiana University School of Medicine Indiana�s EIP - REACH

6. Indiana University School of Medicine Patients First Chronic Care Model with Activated Patients (self-management support) Immersion Weeks Ownership of a crafted patient panel Non-traditional patient care Group visits, home visits, integrated visits with specialists Experiment with technology

7. Indiana University School of Medicine Patients First - Metrics Disease Registries Physician Report Cards with Quality Indicators Continuous Quality Improvement Projects per site ACIC survey of clinic environment Patient Satisfaction Clinic staff evaluation of residents

8. Indiana University School of Medicine Indiana�s EIP - REACH

9. Indiana University School of Medicine Patients Safe Inpatient Component On-line modules on patient safety Safety goals and Epidemiology of harm Reporting Mechanism Patient Safety Forum Drive Systems Changes to Prevent Harm Campus-wide

10. Indiana University School of Medicine Patients Safe - Metrics GME patient safety culture survey Reporting behavior Resident-championed system changes Handoffs Measure face to face time resident audit of each other Transition from Inpatient to Outpatient Re-admission, appointments kept

11. Indiana University School of Medicine Indiana�s EIP - REACH

12. Indiana University School of Medicine Leading Change Resident as Mentor Expand success with Model for Improvement and CQI projects Grassroots Citizenship Committees Leadership Training Give an exampleGive an example

13. Indiana University School of Medicine Leading ChangeCitizenship Committees Wishard Action Committee Clarian Action Committee VA Action Committee Patient Safety Committee IT Committee Wellness Committee Curriculum Committee CQI Steering Committee EIP Evaluation Committee

14. Indiana University School of Medicine Leading Change - Metrics QI projects in faculty practice venues Resident satisfaction/faculty satisfaction Effectiveness of Committee Keeping minutes Subsequent changes in system Leadership 360-degree tool Graduate Survey Give an exampleGive an example

15. Indiana University School of Medicine The Challenges Time and Money Paradigm shift within an academic medical center Tapping into faculty expertise and commitment Demonstrate progress, outcomes Help our identity and our uniqueness Not to shift onto faculty Requires comprehensive public policy initiative and revised reimbursement schemes Reimbursement will need to follow � we suspect that the national leaders of internal medicine will use these data from the EIP programs to justify the shift of dollars to follow patient-centered coordinated safe care.Help our identity and our uniqueness Not to shift onto faculty Requires comprehensive public policy initiative and revised reimbursement schemes Reimbursement will need to follow � we suspect that the national leaders of internal medicine will use these data from the EIP programs to justify the shift of dollars to follow patient-centered coordinated safe care.

16. Indiana University School of Medicine REACH Team To Date EIP Steering Committee Lisa Harris Tom Inui John Fitzgerald Herb Cushing Brad Allen Chris Suelzer Kevin Helms Leading Change Steering Committee John Black and Alex Djuricich, co-chairs Glenda Westmoreland Deb Litzelman Charlie Clark Tom Inui Steve Bogdewic Betsy Lee John Kohne

17. Indiana University School of Medicine