This summer, Ryan Schulteis, MD, will become the Durham VA’s inaugural chief resident of quality improvement and patient safety.
One of 19 such residents across the country, Dr. Schulteis will usher the VA into a new era of quality improvement (QI) by leading QI projects, receiving expert training from mentors at Duke and participating in a national curriculum meant to help usher in a new generation of QI leaders who will help organize the VA house staff to implement QI initiatives.
Schulteis will be under the guidance of Dave Simel, MD, vice chair for Veterans Affairs in the Department of Medicine.
“A resident may have lots of ideas for how things should be improved,” said Simel. “But until now there has been no framework. No one will have more access to the house staff than Dr. Schulteis in this new position.”
W. Edwards Deming, an American statistician who worked in post-war Japan, was one of the most important thinkers of the mid-20th century, but most doctors have probably never heard of him.
Schulteis, however, has been studying Deming and his theories about how to improve systems and organizations as part of his QI training. Quantitative measures like checklists, on-the-job-training and the use of standardized methods of measurement are the cornerstone’s of Deming’s teachings, and to Schulteis, the rigor of Deming’s philosophy makes sense in the hospital setting.
“There’s a science behind QI,” said Schulteis. “It’s well-established, like basic science.”
The problem, Simel and Schulteis said, is that most physicians who have ended up in leadership roles have little training in QI.
“It used to be that if you were a reasonably good doctor you got chosen to be in charge,” said Simel. “But that didn’t mean you had the skills to be a clinical administrator.”
Schulteis, a Wisconsin native who attended the University of Wisconsin in Madison, is on his way to developing both his clinical and administrative skills, and the VA offers an unique environment to in which to become a leader.
Because the VA has a nationally connected network and database of patients, the system has been issuing hospitals with report cards since the 1990s, when the VA underwent what Simel, who’s been at the Durham VA Medical Center (DVAMC) for 34 years, called a “quality revolution.”
The DVAMC has been using electronic health records for 25 years, and since 1988 has used these records to note lab data, pharmacy and progress notes. Because the VA system by and large removes factors like socioeconomic bias and access to care, it provides an ideal testing ground for quality improvements. This offers a wealth of data that can be mined for trends and analysis, something Schulteis said excites him about his upcoming year.
For Schulteis, his new role as chief resident of QI means he can use his background in statistics to begin efforts like an improvement in blood glucose control for VA patients and a project that looks at readmission rates for veterans with hypertension.
“I’m looking forward to all the opportunities this new position brings,” said Schulteis.
One of 19 such residents across the country, Dr. Schulteis will usher the VA into a new era of quality improvement (QI) by leading QI projects, receiving expert training from mentors at Duke and participating in a national curriculum meant to help usher in a new generation of QI leaders who will help organize the VA house staff to implement QI initiatives.
Schulteis will be under the guidance of Dave Simel, MD, vice chair for Veterans Affairs in the Department of Medicine.
“A resident may have lots of ideas for how things should be improved,” said Simel. “But until now there has been no framework. No one will have more access to the house staff than Dr. Schulteis in this new position.”
W. Edwards Deming, an American statistician who worked in post-war Japan, was one of the most important thinkers of the mid-20th century, but most doctors have probably never heard of him.
Schulteis, however, has been studying Deming and his theories about how to improve systems and organizations as part of his QI training. Quantitative measures like checklists, on-the-job-training and the use of standardized methods of measurement are the cornerstone’s of Deming’s teachings, and to Schulteis, the rigor of Deming’s philosophy makes sense in the hospital setting.
“There’s a science behind QI,” said Schulteis. “It’s well-established, like basic science.”
The problem, Simel and Schulteis said, is that most physicians who have ended up in leadership roles have little training in QI.
“It used to be that if you were a reasonably good doctor you got chosen to be in charge,” said Simel. “But that didn’t mean you had the skills to be a clinical administrator.”
Schulteis, a Wisconsin native who attended the University of Wisconsin in Madison, is on his way to developing both his clinical and administrative skills, and the VA offers an unique environment to in which to become a leader.
Because the VA has a nationally connected network and database of patients, the system has been issuing hospitals with report cards since the 1990s, when the VA underwent what Simel, who’s been at the Durham VA Medical Center (DVAMC) for 34 years, called a “quality revolution.”
The DVAMC has been using electronic health records for 25 years, and since 1988 has used these records to note lab data, pharmacy and progress notes. Because the VA system by and large removes factors like socioeconomic bias and access to care, it provides an ideal testing ground for quality improvements. This offers a wealth of data that can be mined for trends and analysis, something Schulteis said excites him about his upcoming year.
For Schulteis, his new role as chief resident of QI means he can use his background in statistics to begin efforts like an improvement in blood glucose control for VA patients and a project that looks at readmission rates for veterans with hypertension.
“I’m looking forward to all the opportunities this new position brings,” said Schulteis.