Background: Despite the push for resident and faculty involvement in patient safety (PS) and quality improvement (QI), there is limited literature describing programs that train them to conduct PS/QI projects. Objective: To determine the effectiveness of a co-learning PS/QI curriculum. Method: The authors implemented a co-learning (residents and faculty together) PS/QI curriculum within our general Internal Medicine program over 1 year. The curriculum consisted of two workshops, between-session guidance, and final presentation. The authors evaluated effectiveness by self-assessment of attitude, knowledge, and behavior change and PS/QI project completion. Results: Thirty-eight of 32 (95%) resident and 8 faculty member participants attended the workshops and 27 of 40 (67%) completed the evaluation. Participants (87-96%) responded favorably regarding workshop effectiveness. The authors found significant improvement in 78% of items pertaining to PS/QI knowledge/skills, but no difference for attitudinal items. The final project evaluation participants rated project content as relevant to learning needs (75%); training as well-organized (75%); faculty mentorship for the project as supportive (75%); and the overall project as excellent or very good (71%). Conclusion: The authors successfully demonstrated a framework for co-teaching faculty and residents to conduct PS/QI projects. Participants acquired necessary tools to practice in an ever-evolving clinical setting emphasizing a patient-centered and quality-focused environment.
The University of California at Berkeley's (UCB) Center for Extreme Ultraviolet Astrophysics (CEA), in conjunction with NASA's Ames Research Center (ARC), has implemented an autonomous monitoring system in the Extreme Ultraviolet Explorer (EUVE) science operations center (ESOC). The implementation was driven by a need to reduce operations costs and has allowed the ESOC to move from continuous, three-shift, human-tended monitoring of the science payload to a one-shift operation in which the off shifts are monitored by an autonomous anomaly detection system. This system includes Eworks, an artificial intelligence (AI) payload telemetry monitoring package based on RTworks, and Epage, an automatic paging system to notify ESOC personnel of detected anomalies. In this age of shrinking NASA budgets, the lessons learned on the EUVE project are useful to other NASA missions looking for ways to reduce their operations budgets. The process of knowledge capture, from the payload controllers for implementation in an expert system, is directly applicable to any mission considering a transition to autonomous monitoring in their control center. The collaboration with ARC demonstrates how a project with limited programming resources can expand the breadth of its goals without incurring the high cost of hiring additional, dedicated programmers. This dispersal of expertise across NASA centers allows future missions to easily access experts for collaborative efforts of their own. Even the criterion used to choose an expert system has widespread impacts on the implementation, including the completion time and the final cost. In this paper we discuss, from inception to completion, the areas where our experiences in moving from three shifts to one shift may offer insights for other NASA missions.
