Creating Optimal Clinical Learning Environments Through Interprofessional Bedside Rounding Models: Lessons From the...

Area of Science:

• Medical Education
• Healthcare Systems Engineering
• Patient Safety

Background:

• The Accreditation Council for Graduate Medical Education's Pursuing Excellence in Clinical Learning Environments (CLE) project spurred the development of innovative educational models.
• Optimal clinical learning environments (CLEs) emphasize team-based, interprofessional collaborative care and innovation in patient safety and quality improvement.
• Systems engineering principles, including design thinking, can be applied to refine healthcare delivery and education models.

Purpose of the Study:

• To describe the development and implementation of the Interprofessional Partnership to Advance Care and Education (iPACE) model at Maine Medical Center.
• To evaluate the impact of the iPACE model on resident education, patient care, and health system outcomes.
• To highlight the potential of interprofessional bedside rounding models to foster essential skills for collaborative, patient-centered care.

Main Methods:

• The iPACE model was developed using systems engineering principles, including design thinking, for iterative improvement.
• Implementation began as a pilot on an inpatient unit and evolved into a standard for bedside rounds.
• The model received support from an American Medical Association grant and health system leadership.

Main Results:

• The iPACE model received positive patient feedback and demonstrated benefits for care team members and resident education.
• The model proved valuable to the health system, showing sustained reductions in length of stay and cost of care.
• Learner benefits included increased faculty observation and improved feedback quality.

Conclusions:

• The iPACE model successfully redesigned clinical learning environments to expose residents to high-functioning interprofessional teams, enhancing patient care and safety.
• Interprofessional bedside rounding models like iPACE are crucial for developing essential collaborative care skills in medical learners.
• Strategies to enhance resident and faculty engagement are vital for maximizing the educational benefits of bedside rounding models.