The Barnes-Jewish Hospital Patient Safety and Quality Fellowship Program provides hands-on experience for junior faculty interested in leading and advancing patient safety and health care quality.
Established by the Goldfarb Foundation, the program continues to be supported by the Foundation for Barnes-Jewish Hospital. It offers opportunities for physicians to focus on process improvements for which they have a passion, while developing leadership skills within a mentoring environment.
Thomas Ciesielski, MD, Washington University Instructor of Medicine, is the current patient safety and quality fellow. He is in his second year of the fellowship. Dr. Ciesielski’s project focuses on standardizing physician-to-physician communication at the time of handoff in a patient’s care.
As a chief resident, Dr. Ciesielski had noticed some of the negative consequences of poor physician-to-physician communication. “With no standard process, important information can be missed,” he says.
According to the Joint Commission, most sentinel events occur because of miscommunication. “Other consequences of poor physician communication include additional testing that may not be necessary and redundancies in work,” says Dr. Ciesielski.
Dr. Ciesielski developed a handoff tool, which is adapted to the hospital’s electronic medical record system, and a formal training module for residents. Residents complete the module online and are tested before and after. “The module provides them with a better understanding of handoff and the importance of a more formal process. There is significant evidence that handoffs with a standardized format improve patient outcomes,” he says.
Dr. Ciesielski is participating in the Improvement Advisory Training Program at the Boston Institute for Healthcare Improvement where he is working to increase the completeness of written handoffs.