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Systems-Based Practice 20 Years On: Navigating the System for Better Care.

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Systems-based practice (SBP) remains challenging to implement in medical education despite its importance for patient safety. Harmonized Milestones 2.0 and new guides aim to standardize SBP education across specialties.

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Area of Science:

  • Medical Education
  • Health Systems Science
  • Quality Improvement

Background:

  • Systems-based practice (SBP) was established as a core competency in 1999 for healthcare quality and safety.
  • Despite its importance, medical educators and trainees still face challenges in understanding and implementing SBP.
  • Previous milestone development led to heterogeneity, prompting a need for a unified approach.

Purpose of the Study:

  • To explore the history and challenges of implementing Systems-based practice (SBP) in medical education.
  • To introduce the Harmonized Milestones 2.0 and supplemental guides designed to standardize SBP competency.
  • To provide suggestions for leveraging new resources to improve SBP education and practice.

Main Methods:

  • Review of the evolution of Systems-based practice (SBP) competency and its milestones.
  • Analysis of the development of Harmonized Milestones 2.0 to create a shared language for SBP.
  • Discussion of challenges and proposed strategies for SBP implementation using new educational tools.

Main Results:

  • The Harmonized Milestones 2.0 define SBP through three subcompetencies: patient safety/quality improvement, systems navigation, and the physician's role in healthcare systems.
  • New supplemental guides offer practical examples for applying SBP in complex healthcare settings.
  • Despite available resources, significant work is still needed for effective SBP implementation.

Conclusions:

  • The Harmonized Milestones 2.0 and supplemental guides represent a significant step toward standardizing Systems-based practice (SBP) education.
  • Addressing implementation challenges requires collaborative effort from the academic medicine community.
  • Advancing SBP is crucial for professional development and ensuring high-quality, safe patient care.