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Pursuing Excellence

Pursuing Excellence Kicks-Off Pathway Innovators

The Pathway Innovators recently gathered at the ACGME Headquarters in Chicago to kick off their four-year journey of innovation as part of the Pursuing Excellence in Clinical Learning Environments initiative. The selection of the eight sites that make up the Pathway Innovators group presents a unique opportunity to test and model effective practices for the entire graduate medical education community.

The three-day meeting allowed the institutions to share their proposals and receive critical feedback from CEOs and team members to refine their projects. They worked in small groups to articulate their organization-specific visions from the perspectives of patients, residents, faculty members, and executive team members.

During rapid-fire feedback rounds, the Innovators embraced their role as incubator sites exhibiting important agility and teamwork. In addition, the teams began initial work on defining measurement strategies, which included identifying key outcomes, processes, and potential unintended consequences that will shape their approach. The group also began work as a collaborative to conceptualize new approaches to faculty engagement.

The initial projects of the eight sites focus on two areas identified by the CLER National Report of Findings 2016 as drivers of change - interprofessional development and resident engagement in system-based efforts to improve patient safety and health care quality.

The Pathway Innovators’ initial projects are:

  • Children’s National Medical Center – Implementation of an in situ (in the clinical setting) simulation program across the organization to assess and develop the workforce's knowledge and capacity to improve patient safety and health care quality.
  • Cleveland Clinic Foundation – Establishment of resident-led and faculty-coached multidisciplinary teams to explore transitions of care, identify vulnerable components, and deficiencies, and propose and implement solutions.
  • Dell Seton Medical CenterUniversity of Texas at Austin – Implementation of clinical learning environment-engaged curriculum to provide residents with patient-focused learning experiences that increase efficiency, reduce errors, improve educational outcomes for learners, and enhance patient satisfaction.
  • Maine Medical Center – Redesign of interprofessional clinical learning and care environments to be patient-centered and include greater resident engagement in addressing patient safety and health care quality, and enhanced provider and staff well-being and satisfaction.
  • Our Lady of the Lake Regional Medical Center – Targeted education and embedded “on-the-fly” coaching that includes nurses, physician assistants, students, residents, and attending physicians to increase event reporting behavior.
  • Strong Memorial Hospital of the University of Rochester – Integration of residents into a Unit-based Performance Program (UPP) to improve patient outcomes and satisfaction, and advance priorities of quality and safety, patient- and family-centered care and efficiency.
  • University of Chicago Medical Center – Expansion of the IGNITE program (Improving GME Nursing Interprofessional Team Experiences) to enable frontline nurses and residents to work together to improve interprofessional communication and quality of care.
  • University of California San Francisco (UCSF) School of Medicine – Integration of residents and fellows into unit-based leadership teams and the Lean Management System focused on improving transitions of care both within and outside the institution.


Over the next four years these eight institutions are the testing ground for innovative approaches to crafting effective clinical learning environments that can translate to the more than 800 accredited Sponsoring Institutions
Kevin B. Weiss, MD, MPH, ACGME Senior Vice President, Institutional Accreditation

The Pursuing Excellence framework from which the Innovators are working is based on overarching findings identified through site visits conducted as part of the ACGME’s Clinical Learning Environment Review (CLER) Program. More information about the results from the CLER Program can be found in the National Report of Findings 2016 Issue Brief No, 1 Executive Summary .

As the Pathway Innovators identify successful practices, they will share their experiences through existing ACGME forums, as well as develop new avenues for sharing with the broader community, encouraging a national discussion about advancing the quality of educational and patient outcomes within health care settings.

The Pathway Innovators will meet three times a year for the next four years, once per year at the ACGME office, and twice per year alternating across the participating institutions, to collaborate and share their progress and findings.

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