Quality of Experience  

In the Infectious Diseases Fellowship program at Harbor-UCLA Medical Center, every effort is made to provide the highest-possible quality in experience and training for each Fellow.  Examples of this process include:

 

     Overall Evaluation of Fellow Performance:  Following each research service period (either clinical or research), the Fellow will be evaluated by appropriate Faculty who have supervised the Fellow.  The means of evaluation will be through a formal written evaluation, with commentary on strengths and weaknesses (see formal evaluation process described elsewhere in the Program), along with a discussion among the Faculty of the overall performance of the Fellow.  In this way, feedback and constructive critiques will be provided back to the Fellow in a timely manner such that: 1) deficiencies can be addressed prior to ensuing research service periods; 2) those activities that are performed at a high-quality level will be reinforced; and 3) the overall Fellow performance is optimized in the context of completing an original research project that is anticipated to receive peer approval such that it may be publishable in the infectious disease literature.

Quality Assurance and Improvement  

 

      A diverse venue of activities and experiences comprise our ongoing quality assurance and quality improvement programs.  Among other opportunities in this regard are regular conferences and meetings afford Fellows insights and perspectives from which to gain knowledge, skill, and wisdom to improve quality of care:

 

A.  Morbidity and Mortality Conference

 

       The weekly Morbidity and Mortality Conference is the primary mechanism by which the Fellow receives training in quality assurance and improvement.  These weekly hour-long conferences provide a formal context in which the Fellow takes part in selected case presentations and review for the purpose of assessing quality of care.  In this setting, which is coordinated and supervised by Attending Clinical Faculty, Chief Residents review all cases (eg., patient history, charts / data, differential diagnosis, and decision-making strategies) relating to patients that expire on the Medicine service.  It is considered particularly important to include any available results from autopsy in the discussion related to quality assurance and improvement.  In this process of peer review of quality of care assessment and feedback, the Fellow gains experience in interpreting quality assurance and translating that information into improvement in quality of care when possible.  In addition to this ongoing review process, Fellows are provided selected didactic presentations relating to topics such as risk management and cost-effectiveness in medical practice.

 

B.  Antibiotic Review Committee

 

       The monthly Antibiotic Review Committee meeting is a 2-4 hour discussion of key issues relating to antibiotic use, restriction, formulary, and cost-effectiveness.  Issues regarding choice of antibiotics, policy decisions pertaining to institutional use of distinct antimicrobial agents, comparative evaluation of novel vs. conventional agents, drug-drug interaction information, changing FDA approval status of anti-infective agent indications and approvals, & overall cost-effective use of antibiotics with these considerations are all addressed in these meetings.  Additionally, an integral activity of the Antibiotic Review Committee is its regular participation in reviews of ongoing antimicrobial susceptibility profiles of isolates from patients on the wards.  The Fellows are key component of this meeting as they are exposed first-hand to Faculty and Administrative decision-making related to appropriate standard of care and utilization of antimicrobial agents within and beyond the hospital environment (eg., inpatient and outpatient considerations).  These meetings are conducted by Infectious Diseases and HIV Medicine attending Faculty and Fellows, and Clinical Pharmacists & specialty Faculty who are related to specific discussions. 

 

C.  Infection Control Committee

 

      The Infection Control Committee is comprised of Infectious Diseases and HIV Attending Faculty and Fellows, with Infection Control Nurses, Microbiology Laboratory supervisors, and other specific Epidemiology Coordinators.  The Committee considers topics relating specifically to monitoring, characterizing, reporting, and educating medical professionals with the goal of preventing, identifying, isolating, and minimizing patient-to-patient spread of nosocomial infections.  The Committee pays particular attention to outbreaks caused by drug-resistant pathogens.  This Committee meets monthly or more frequently as may be necessitated by current outbreak or other urgent epidemiological requirements.