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Integrating Quality Improvement and Continuing Professional Development: A Model From the Mental Health Care System
Sanjeev Sockalingam1, Hedieh Tehrani, Elizabeth Lin
1S. Sockalingam is deputy psychiatrist-in-chief, Toronto General and Princess Margaret sites, University Health Network, director of continuing professional and practice development, and associate professor, Department of Psychiatry, University of Toronto Faculty of Medicine, Toronto, Ontario, Canada. H. Tehrani is research assistant, Department of Psychiatry, University of Toronto Faculty of Medicine, Toronto, Ontario, Canada. E. Lin is associate professor, Department of Psychiatry, University of Toronto Faculty of Medicine, and adjunct scientist, Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada. S. Lieff is vice chair of education and professor, Department of Psychiatry, University of Toronto Faculty of Medicine, Toronto, Ontario, Canada. I. Harris is professor and head and director of graduate studies in health professions education leadership, Department of Medical Education, University of Illinois College of Medicine, Chicago, Illinois. S. Soklaridis is education scientist, Centre for Addiction and Mental Health, and assistant professor and head of research, innovation, and scholarship in education, Department of Psychiatry, University of Toronto Faculty of Medicine, Toronto, Ontario, Canada.
Purpose:
To explore the perspectives of leaders in psychiatry and continuing professional development (CPD) regarding the relationship, opportunities, and challenges in integrating quality improvement (QI) and CPD.
Method:
In 2013-2014, the authors interviewed 18 participants in Canada: 10 psychiatrists-in-chief, 6 CPD leaders in psychiatry, and 2 individuals with experience integrating these domains in psychiatry who were identified through snowball sampling. Questions were designed to identify participants' perspectives about the definition, relationship, and integration of QI and CPD in psychiatry. Interviews were recorded and transcribed. An iterative, inductive method was used to thematically analyze the transcripts. To ensure the rigor of the analysis, the authors performed member checking and sampling until theoretical saturation was achieved.
Results:
Participants defined QI as a concept measured at the individual, hospital, and health care system levels and CPD as a concept measured predominantly at the individual and hospital levels. Four themes related to the relationship between QI and CPD were identified: challenges with QI training, adoption of QI into the mental health care system, implementation of QI in CPD, and practice improvement outcomes. Despite participants describing QI and CPD as mutually beneficial, they expressed uncertainty about the appropriateness of aligning these domains within a mental health care context because of the identified challenges.
Conclusions:
This study identified challenges with aligning QI and CPD in psychiatry and yielded a framework to inform future integration efforts. Further research is needed to determine the generalizability of this framework to other specialties and health care professions.
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