ACGME Milestones
The Rush Emergency Medicine Residency Patient Safety and Quality Improvement curriculum is based on the ACGME EM Milestones version 2.0, enacted in July 2021. As you’re aware, through your residency you’ll need to demonstrate proficiency in the various levels described in the milestones below. Both of these fall within the Competency Domain of Systems-Based Practice.
Level 1 | Level 2 | Level 3 | Level 4 | Level 5 |
Demonstrates knowledge of common patient safety events Demonstrates knowledge of how to report patient safety events | Identifies system factors that lead to patient safety events Reports patient safety events through institutional reporting systems (simulated or actual) | Participates in analysis of patient safety events (simulated or actual) Participates in disclosure of patient safety events to patients and families (simulated or actual) | Conducts analysis of patient safety events and offers error prevention strategies (simulated or actual) Discloses patient safety events to patients and families (simulated or actual) | Actively engages teams and processes to modify systems for preventing patient safety events Acts as a role model and/or mentor for others in the disclosing of patient safety events |
Level 1 | Level 2 | Level 3 | Level 4 | Level 5 |
Demonstrates knowledge of basic quality improvement methodologies and metrics | Describes local quality improvement initiatives (e.g., emergency department throughput, testing turnaround times) | Participates in local quality improvement initiatives | Demonstrates the skills required for identifying, developing, implementing, and analyzing a quality improvement project | Creates, implements, and assesses quality improvement initiatives at the institutional or community level |
Patient Safety
- Knowledge of Patient Safety Events
- Safety Culture
- Establishing a Safety Culture (aka Blame and Punishment are Counterproductive)
- Reporting Errors at Rush:
- The TRIPSS system
- Analysis of safety events
- Disclosing errors to patients and families
- Simulation curriculum
Quality Improvement
- Basic quality improvement methodologies