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Interviewing Medical Students Supporting QI Project Work

We sat down with two first-year medical students at UBC, Daniel Wong, and Vanessa Kong to hear about their experience in supporting Dr. Lingsa Jia’s QI Projects. Dr. Lingsa Jia is the head of the Burnaby Hospital (BH) Addictions Medicine Consult Team (AMCT).

Daniel has been involved with the QI project “Exploring gaps in knowledge and demographic factors of patients with substance use disorders” which reviews who the patients are that the AMCT has been serving, what kind of clinical characteristics they have and, what the team has been doing for them over the past year, whether it be drug interventions or connecting them to community resources. The scope of his work included a retrospective chart review in Meditech. [See Poster]

Vanessa has been supporting the work on the QI Project, “Knowledge Assessment and Translation of Substance Use Resources” which aims to bridge the knowledge gap between addiction medicine resources and healthcare providers. She is supporting the development of a tool that brings together substance use information from both Fraser Health Areas and Vancouver Coastal into one place. [See Poster]

The interview below has been paraphrased for the purpose of this article.

Can you share some interesting project findings?

D: I’ve been working with data from Meditech to do a retrospective chart review, and one interesting finding is that ages of patients are between 21 and 82. This really shows that substance use disorders affect everyone and do not discriminate based on age. Another finding is that many of the patients have unstable housing or live in poor financial situations. In addition, a lot of patients leave against medical advice which affects the care they receive and our ability to connect them to the outpatient world.

V: There is a disconnect for providers on where to find the right information on addiction medicine and community support for their patients. BH is a special challenge because it’s between the borders of VCH and FH and community services are often curated based on patient address. Additionally, I’ve learned that no matter what area of healthcare, people acknowledge that there is a need to learn more about addiction medicine to better support patients. This validated that what I am doing for QI will be beneficial for the hospital.

How did you get involved in this QI Project?

V: Before I started medical school I had an interest in mental health and mental health-related illnesses. Prior to my research block, I browsed the catalog of listed projects and found Dr. Jia’s project particularly relevant to my prior experience and saw it as an opportunity to learn more. During my undergrad years, I created a consolidated list of UBC Mental Health Resources which is similar to what I’m doing now.

D: I was already looking for QI-related work because I had done some QI work before medical school. In research, it can be really difficult to make changes quickly, but in QI you can see where you make a direct impact right away and measure that impact over cycles. I’m only in my first year, so I haven’t fully decided where I’m going yet but one of the areas I’m considering is family medicine. With the opioid epidemic at the forefront of health care right now, developing a knowledge base with addictions medicine seems like a good place to start as i can be applicable to lots of different specialties.

What did you learn from this experience?

V: This is my first time working in a hospital setting and getting to know the processes of patient care. It made me realize there is a lot of change to be done. I learned that there was a need for more addiction medicine care at BH and how much of a positive impact the AMCT had when it was formed.

D:  Although I had worked on a QI project in the past, this was the first time I was really exposed to the science of QI. A lot of it was thanks to Janice Eng. She was able to give us a unique perspective that I wasn’t aware of before and it’s inspiring to see that there is a real movement behind QI. She had us work on the IHI modules to build our QI foundation for future projects. And we also had the opportunity to present our projects at the QI Cafe.

What does being part of this project mean to you and how will it impact the way you think about your future career in healthcare? 

D: I found that QI is really rewarding. In the past 5-6 weeks, we accomplished more than I imagined. It really goes to show the power of QI and it’s ability to impact healthcare. I am definitely going to remember this in the future and hope to have the energy to continue QI work after all my training.

V: Through this work I realized the importance of community and understanding different sectors of healthcare.  It really highlights the idea that integration and collaboration across departments are really needed when providing optimized patient care. Having the ability to communicate, listen and see each other’s perspectives is so important, especially when it comes to something as complex as addiction medicine.

How do you think QI will impact healthcare in the future?

V: Hopefully, QI will help to establish new ways to promote efficiency in healthcare and reduce resource costs. Rather than always discovering completely new strategies we can find ways to rework the old ones. QI is about making small improvements over time, small PDSA cycles, and you can really see that over time it makes a big impact.

D: In one of the IHI modules it talked about how being stagnant is never good thing especially when it applies to healthcare. I think that QI is going to be here to stay. There are many areas of improvement when we look for them.

Any last words?

D: Dr. Jia and Janice did a really great job hand-holding us, having weekly meetings with us on Monday mornings or Friday afternoons. They spent a lot of time with us. This experience has given me a good foundation for future QI projects. And I look forward to continuing with this project and starting a new PDSA cycle.

V: None of this could have happened without our supervisors and mentors. Dr. Jia and Janice. I didn’t know much about QI until I started on this project. I want to thank them for their time and effort, to teach, check-in, and guide us along the way as well as all the other people that have supported us. Change happens when you’re able to lend a helping hand and educate the people around you.

Thank you to Daniel and Vanessa for sharing their experience with us. They are currently still working with Dr. Lingsa and we look forward to hearing more about their progress. If you and/or your colleagues is interested in starting a QI project or finding out more please contact Janice Eng – Janice.Eng@fraserhealth.ca