By Eric Eraso | June 5, 2024 1:57 pm

Members of UCF’s inaugural Internal Medicine residency presented their projects on ways to improve patient care during the 10th Annual Quality and Patient Safety Forum May 30.

The projects featured included ways to increase naloxone prescriptions for opioid-based hospitalizations, improving communication between day and night shift providers, and how to refer more patients to cardiac rehabilitation to reduce hospital readmissions and deaths.

“It is fantastic to see these learners conducting this [work],” said Dr. James Goff Jr., the event’s plenary speaker who is chief medical officer of the Veteran’s Affairs Mid-Atlantic Health Care Network, Veterans Integrated Service Network 6. “The healthcare system is complex and it can be hard to have an impact, but in these projects we saw teams that are not only having an immediate impact, but will have a lasting impact that continues after they are gone.”

Residents are required by the Accreditation Council of Graduate Medical Education to conduct quality improvement work during their training. This forum gives them the opportunity to share their experience with each other, attending physicians and hospital leaders. This year’s forum was held at Nemours Children’s Health in Lake Nona, a College of Medicine education and research partner.

Residents cited QI as a key aspect of their growth because it helps them learn more about the healthcare system and think critically about how to improve it.

 “Hospitals don’t just want you to show up, see your patients and leave, they want you to help make the hospital better,” said Dr. Guru Chinnaraj, chief resident at HCA Florida Osceola Hospital, one of the residency’s locations. “Having this QI experience during residency helps them participate in QI as a doctor, which is good for their career and good for patient care.”

At a previous forum during his residency, Dr. Chinnaraj and his team presented work on optimizing oxygen therapy for hospitalized patients.

The Internal Medicine Residency of Greater Orlando – Osceola is a partnership between the College of Medicine, HCA Healthcare and the VA. Started in 2014, it was the first sponsored by the UCF-HCA Graduate Medical Education Consortium, which is now one of the fastest growing programs in the state. By July, the consortium will be training more than 620 residents and fellows across Florida.

Dr. Goff oversees more than 22,000 providers and staff, across 53 VA care sites. He urged residents to be change agents by communicating the problems they see with leaders across the organization. Only through communication can effective change happen, he said.

To make that point, he invited several groups of six up to the front of the stage and handed them three tennis balls. He gave them a simple instruction, “you must pass all 3 balls around.”  

His directions were met with confusion. Residents started asking questions about what he wanted specifically and the metric for success. He simply encouraged them to do their best.

The first group passed the tennis balls individually and completed the task it in 30 seconds. The next groups used various methods of passing the balls at the same time and were much faster.

“It was a simple task and it started with confusion, but as time went on, the groups were able to improve,” he explained. “In healthcare, we work in very complex systems. Understand, it is not easy, but just like in this exercise, we can improve.”

After closing his speech, Dr. Goff was presented with a challenge coin by Dr. Thompson, the associate chief of staff of Education at the Orlando VA Medical Center. A challenge coin, a tradition rooted in the military, is typically awarded to acknowledge significant achievements.

When Dr. Goff accepted the coin; he reached in his pocket and pulled out another challenge coin he had received previously. He explained, “I always carry it with me in my pocket to remind me of the soldiers who never came back home,” he said. “On my most difficult days, the staff will see me rubbing it in my pocket, and when I do that, I am thinking about what I do, and the people I do it for.”

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