Anjala V. Tess, M.D., is a leading educator in patient safety, currently designing and directing programs at Beth Israel Deaconess Medical Center (BIDMC) and Harvard Medical School (HMS) in Boston. At BIDMC she is Associate Chair for Education in the Department of Medicine and co-created the Stoneman Elective in Quality Improvement and Patient Safety. She is currently Primary Investigator and Co-Director of the HMS Fellowship in Quality at Harvard Medical School, and is Program Director for the HMS Master in Quality and Safety. Dr. Tess is a practicing hospitalist at BIDMC.
The Betsy Lehman Center: In keeping with the American College of Graduate Medical Education’s (ACGME) preference for experiential learning, BIDMC has been involving residents in improvement projects for nearly 20 years. What are some of the advantages and challenges of that approach from the perspective of the hospital, as well as the residents and senior staff members?
Dr. Tess: Trainees are the frontline experts at academic medical centers — they know what actually works and what doesn’t, where the gaps exist, and where workarounds are necessary to get things done. By tapping into these under-recognized experts, hospital leaders benefit from their specialized knowledge, the process is better understood and potential fixes can be more effective. In the Department of Medicine at BIDMC, we encourage trainees to use the reporting system and expose them from week one to our system-oriented Morbidity and Mortality conference. As residents progress, we assign them to do live event reviews and participate in projects to fix the system.