748 - iSPOT an Improvement: Improving and Standardizing Peer Observation and Feedback in PHM Teams
Friday, April 28, 2023
5:15 PM – 7:15 PM ET
Poster Number: 748 Publication Number: 748.119
Nicole Webb, Valley Children's Healthcare, Madera, CA, United States; Erin King, Children's Hospitals and Clinics of Minnesota, Minneapolis, MN, United States; Priti Bhansali, Children's National Health System, Washington, DC, United States; Joanne Nazif, The Children's Hospital at Montefiore, Scarsdale, NY, United States; Cherie Ginwalla, UC Davis, Sacramento, CA, United States
Program Director, Pediatric Hospital Medicine Fellowship Valley Children's Healthcare Madera, California, United States
Background: Peer observation and feedback (POF) allows clinicians to observe and learn from each other via obtaining concrete strategies for improvement. In a 2019 national study of pediatric hospitalists, 60% of participants had experienced POF but most had no division expectation to participate. Participants strongly endorsed a desire for POF in their practice setting and found it to be valuable for faculty development, however formal structure was lacking. This was the basis for creating iSPOT: Improving and Standardizing Peer Observation in PHM Teams. Objective: Global
Aim: Formalize, standardize and normalize POF in Pediatric Hospital Medicine (PHM). SMART
Aim: To increase POF events by 20% from baseline, or if starting from zero, to include 20% of the members of the practice group. Design/Methods: The study is AAP MOC4 sponsored and IRB approved. 21 sites enrolled. Baseline number of POF events was obtained from each site. Participants joined institutional POF efforts, submitted personal improvement goals, and attended quarterly webinars during which QI education was provided, data were reviewed, and plans for improvement activities were made. Site leaders collected data and implemented interventions to increase POF events. Characteristics of exemplary sites were shared. Baseline and quarterly data for 12 months were depicted using run charts. Outcome measures were number of POF events, self-reported satisfaction of participants in their clinical role, confidence in feedback, percent participation at each site, collegiality, and attainment of individualized goals. Process measures were the number of participating sites with access to a tool for POF and percent participants at each site. Balancing measure was time spent in POF.
Results: Figure 1 depicts the project key driver diagram. Figure 2 depicts total number of POF events during the study compared to the 1-year baseline of all sites. There was a 55% overall increase in POF events from baseline by Quarter 3. Figure 3 depicts participation rates for 2 observations by study site at the time of Quarter 3. 18 of 21 sites achieved the SMART aim. Participant data collection is ongoing and will be finalized in Quarter 4.
Conclusion(s): Creation of a national MOC program for POF provided incentive and infrastructure to increase POF across diverse institutions. Preliminary participant feedback includes perceived benefit to POF with respect to individualized goals and collegiality. Ongoing challenges with the COVID-19 pandemic were identified as barriers. Next steps include expansion to other settings and collaboration with disciplines outside of PHM.
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