LO41: Disrupting quality improvement: integrating design thinking in the emergency department

Introduction/Innovation Concept: Quality Improvement (QI) remains a challenge and has been identified as a key competency by the Royal College of Physicians and Surgeons. Hospitals can be dehumanized environments, both for patients and the staff working there. The distant understandings of each other’s expectations during their health care encounter often create a sense of futility, frustration, and moral distress in therapeutic relationships. The transient nature of interactions and workplace culture in emergency departments (ED) enhances this distress. Methods: Working in a cross-disciplinary fashion, we explored how residents could develop quality improvement initiatives as a way to engage personal interests for QI measures. Key goals for developing these tools were 1) Learn cross-disciplinary tools for observation, inquiry, and improvement, 2) Develop reflective practice for residents, and 3) create ownership for the work and ongoing areas for improvement in local EDs for learners. Curriculum, Tool, or Material: We developed a process that would connect designers, residents, and content experts to an area of QI. Residents will be asked to identify an area in the ED that they field would benefit from a QI project (examples include: trauma team activation, waiting room anxiety, and referral delays from the ED). Working with designers and stakeholders (including patient representatives), learners would map the experience of a particular project. Strengths and opportunities for improvements would be identified at each step of the project. The team would then prototype solutions which will be presented to site chiefs for implementation and evaluation. Conclusion: Working with designers offers a practical and powerful approach to undertaking QI projects in the ED. We hope that this process allows residents to undertake projects that they are personally invested in and helps build longitudinal relationships beyond direct clinical work with the local ED they are working in