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Exemplary Care and Learning Sites: A Model for Achieving Continual Improvement in Care and Learning in the Clinical Setting
University of Missouri, MO, USA.
hGeisel School Medical Dartmout, NH USA; White River Junct VA Hospital, VT USA.
University of Missouri, MO, USA.
University of Saskatchewan, Canada; Jonköping University, Sweden.
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2016 (English)In: Academic Medicine, ISSN 1040-2446, E-ISSN 1938-808X, Vol. 91, no 3, 354-359 p.Article in journal (Refereed) PublishedText
Abstract [en]


Current models of health care quality improvement do not explicitly describe the role of health professions education. The authors propose the Exemplary Care and Learning Site (ECLS) model as an approach to achieving continual improvement in care and learning in the clinical setting.


From 2008-2012, an iterative, interactive process was used to develop the ECLS model and its core elements--patients and families informing process changes; trainees engaging both in care and the improvement of care; leaders knowing, valuing, and practicing improvement; data transforming into useful information; and health professionals competently engaging both in care improvement and teaching about care improvement. In 2012-2013, a three-part feasibility test of the model, including a site self-assessment, an independent review of each site's ratings, and implementation case stories, was conducted at six clinical teaching sites (in the United States and Sweden).


Site leaders reported the ECLS model provided a systematic approach toward improving patient (and population) outcomes, system performance, and professional development. Most sites found it challenging to incorporate the patients and families element. The trainee element was strong at four sites. The leadership and data elements were self-assessed as the most fully developed. The health professionals element exhibited the greatest variability across sites.


The next test of the model should be prospective, linked to clinical and educational outcomes, to evaluate whether it helps care delivery teams, educators, and patients and families take action to achieve better patient (and population) outcomes, system performance, and professional development.

Place, publisher, year, edition, pages
Lippincott Williams & Wilkins, 2016. Vol. 91, no 3, 354-359 p.
National Category
Family Medicine
URN: urn:nbn:se:liu:diva-130146DOI: 10.1097/ACM.0000000000001072ISI: 000377607500030PubMedID: 26760058OAI: diva2:948548

Funding Agencies|Dorothy Rider Pool Health Care Trust; Office of Medical Education Research and Development, Louisiana State University Health Sciences Center; University of Missouri-Columbia Center for Health Care Quality; Office of Health Services Research and Development, Department of Veterans Affairs [EDU08-426]

Available from: 2016-07-12 Created: 2016-07-11 Last updated: 2016-07-18Bibliographically approved

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Thörne, Karin E.
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Department of Medical and Health SciencesFaculty of Medicine and Health Sciences
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