Program Initiatives

Maintaining Wellness

We have worked with our Office of Clinician Support to increase awareness of existing mental health resources for our residents and faculty, especially during the pandemic with its attendant stress and social isolation. The Office of Clinician Support offers a voluntary opt-out program for residents to screen for anxiety, depression and burnout with confidential referrals for evaluation and treatment.

The BCRP takes pride in promoting activities and programs to enhance the personal and professional development of residents. As an example, we designated January as “Joyuary” and created a series of fun, leisure activities that bring residents and program leaders together. Each year, the Housestaff Association’s sponsors a Winter Formal on the first weekend of February that features a dance competition among the classes.

Residency Program Training Committee

The Residency Program Training Committee (RPTC) is assigned focused educational topics to review in RPTC subcommittees and reports their findings to the residency at large and to the Executive Committee. The committee is made up of resident representatives, chief residents, program leadership and invited faculty from Boston Children’s Hospital and Boston Medical Center.

RPTC will have a major role in monitoring the major changes that we made to the schedule.

Noon Conference

Noon Conference Series in this Academic Year will change: We will feature the best of our didactic teaching conferences and also incorporate other case-based teaching sessions from the Chief Residents and residents on the Teach Rotation. We are making the conference protected and mandatory for all residents except for those in the Brigham NICU and Birth and Transition Rotations, MSICU Rotation, ED Rotations and some Electives. Chief Residents hold beepers to facilitate attendance at Noon Conference.

Work Family Balance Fund

Formed from a generous gift of a BCRP alum, the Work Family Balance Fund supports individual grants to facilitate the academic and professional development of residents who are juggling family needs while pursuing their professional careers. In addition, the fund supports family friendly activities such as movie nights, picnics, apple picking, and the like. A call for individual grants goes out each September.

BCRP Leadership Curriculum

We introduced a Leadership Curriculum spanning all three years that focuses on team leadership within the program and leadership roles in one’s future career with an annual housestaff-wide retreat focusing on leadership topics. In addition, each resident is assigned a leadership mentor to facilitate their leadership roles within the program such as on supervisory rotations, but also with attention to their ongoing leadership skills as they advance in their careers.

BCRP Diversity Council

This group’s activities focus on three important aims: 1) recruitment of individuals with diverse backgrounds, particularly those who are under-represented in medicine, to the BCRP; 2) providing mentorship through the Mentor Me program; and 3) promoting community. It is a priority of our program to attract people who bring diverse perspectives to enhance the program and serve our diverse patient population. The BCRP seeks to attract individuals from diverse backgrounds including, but not limited to race, ethnicity, disability, socioeconomic status, gender identity, and sexual orientation.

The I-PASS Handoff Curriculum

As part of our aim to improve communication and patient safety (reduction in medical errors), we piloted and implemented a standardized approach. We employ a standard language for our verbal handoffs to focus the discussion at evening sign-out. Using our electronic medical record, we developed an electronic handoff tool that imports medical information automatically and residents update text fields within the electronic handoff tool to provide timely information about:

Illness severity
Patient summary
Action list
Situation awareness and contingency planning
Synthesis by receiver

This curriculum is evidence-based and ensures a shared mental model for the care of patients on the team. The pilot study demonstrated a 40% reduction in medical errors, a decrease of time at the computer (roughly 30 minutes per day), and increased time at the bedside (30 minutes per resident per day). On the basis of these results, we are implementing the I-PASS handoff process is implemented across our program. More information about the I-PASS study and the educational curriculum is available at the I-PASS website, and in several publications: Sectish 2010, Starmer 2012, O’Toole 2013 and Starmer 2013.

As we have always done, we continue to emphasize educational scholarship in our program and study the impacts of curricular change.

Another evidence-based initiative is “Bringing I-PASS to the Bedside: Standardizing Patient Centered Communication to Improve Understanding and Enhance Patient Safety.”

This initiative aims to reduce medical errors, improve the patient, family, and provider experiences, and promote a shared mental model of the plan of care. Based on pilot data that patients and families had a discordant understanding of the plan of care, Boston Children’s investigators Alisa Khan and Christopher Landrigan developed an Intervention Bundle and launched a multisite project across North America. They found impressive results, with a 38% reduction in preventable adverse events following implementation of the Intervention Bundle!

We have implemented the new approach to care at Boston Children’s Hospital and Boston Medical Center on the general pediatrics inpatient units The Intervention Bundle consists of:

Engaging and empowering patients and families with an orientation to Patient and Family Centered Rounds on admission
A new format of discussion on rounds based on the organizing framework of the mnemonic, I-PASS, plus a written Rounds Report that summarizes what we discussed
Standardized communication techniques throughout the day and night shifts with an inter-professional Huddle the start of the shift each morning