Department of Medicine Quality and Patient Safety
Welcome to the Department of Medicine’s (DOM) Quality and Patient Safety (QPS) website! Led by Vice Chair Lisa Caruso MD, MPH, and Director of QPS for the DOM Deborah Whalen APRN-BC, MSN, MBA, our robust QPS team works closely with Boston Medical Center’s (BMC) Department of QPS to lead initiatives that support high-quality, safe, equitable, efficient patient centered care for our community. We aim to follow a “just culture” that insures faculty, trainees, staff and students feel safe to report and discuss quality and patient safety concerns. We proactively engage in identifying and reporting safety events and contribute to creating a high-reliability organization. Our strong educational program and Quality Improvement (QI) mentorship for faculty support QI skill development around the Institute for Healthcare Improvement (IHI) Model for Improvement used throughout hospital system in making sustainable change.
Quality Recognition
Institute of Health Care Improvement designation of Boston Medical Center as an Age Friendly Health System –Committed to Care Excellence (AFHS highest level of recognition) led by the DOM Quality leaders Lisa Caruso MD, MPH and Deborah Whalen APRN-BC , MSN , MBA .
Examples of System Wide Quality Initiatives Led by DOM
- Creation of a Mortality Dashboard to signal opportunities for inpatient care teams with the ability to filter by location, age, gender, race, language, and observed/expected ratios
- Development of EPIC Secure Chat and Paging Guidelines which incorporate escalation pathways to ensure effective clinical communication
- Development of a Dobhoff Tube Placement/Nasogastric Feeding Guideline, training video, order set, and a dashboard for monitoring guideline compliance
- Designed and supported a Palliative Care Extender Team to the Emergency Department during BMC’s COVID Response. (Shankar, KN, J Dugad, S Jaiprasert, L Nentwich, L Caruso, D Whalen, A Dobie, P Macip Rodriquez, S Rao, S. Mitchell. Evaluation of an Emergency Department Palliative Care Extender Program on Hospital and Patient Outcomes .West J Emerg Med 2023 May; 24(3):637-643)
Quality and Patient Safety Educational Opportunities in the Department of Medicine
BMC Internal Medicine Resident Curriculum
BMC Internal Medicine Resident Curriculum
—Led by Drs. Shaleen Chakyayil, Lisa Caruso and Ms. Deborah Whalen, the QPS curriculum spans the PGY1 and PGY2 years introducing patient safety in Year 1 followed by experiential learning using the IHI Model for Improvement and faculty-mentored, resident-driven QI projects in Year 2. Residents can attain BMC QI Hub certification based on the quality of their projects and number of PDSA cycles completed. Projects for AY25 were:
- Increasing distribution of naloxone to patients with substance use disorder discharged from BMC
- Reducing 24h readmissions to the MICU for patients transferred out to the floor
- Improve dosing and timing of diuretic dosing in first 24h or admission in patients with heart failure
- Increasing completion of Health Care Proxies in Crosstown Primary Care
- Reducing inappropriate antibiotic allergies for patients admitted to General Medicine teams
- Improving turn-around-time for venous blood gas testing for floor patients
- Increasing Fib-4 screening in patients in Endocrinology Clinic
- Increasing referrals to cardiac rehab for patients admitted with heart failure
- Increasing screening for microalbuminuria in patients with diabetes in Crosstown Primary Care
- Reducing the use of high potassium snacks for patients with hyperkalemia on 7E
- Reducing the use of unnecessary telemetry
- Reducing C Diff infections using contact precaution education for visitors
- Increasing the use of zolendronic acid for patients admitted to medical teams with fragility fractures
Chief Residents Morbidity & Mortality Rounds
Chief Residents Morbidity and Mortality Rounds is presented monthly to review patient safety events and discuss system changes to prevent similar future events.
Quality Chief Resident Opportunity
Each year a BMC Internal Medicine Chief Resident serves as Quality Chief Resident at the Veterans Administration Hospital in West Roxbury to improve care and foster quality improvement opportunities for Internal Medicine Residents during their VA quality and patient safety elective.
Clinician Executive Fellowship in Quality and Patient Safety
Directed by Dr. Nicholas Cordella, this program is a 1 year funded post-residency administrative fellowship in QPS. The goal is to train leaders in clinical quality improvement for future operational roles in department or hospital quality. Eligible applicants are current BMC based house staff/chief residents in their last year of training.
BMC QI Hub
Jointly supported by the BMC Department of Quality and Patient Safety and the Boston University Barry M. Manuel Continuing Medical Education Office, the
QI Hub is BMC Health System’s educational home for continuing professional development in quality improvement. The QI Hub not only supports BMC’s Improvement Leadership Academy but also provides opportunities for attaining QI certification at four levels of achievement based on participating in or leading QI projects at BMC – Bronze, Silver, Gold and Diamond. In addition, it provides consultative services to faculty interested in feedback on their QI initiatives.
Improvement Leadership Academy
A five-month course led by Natalie Sanfratello and Dr. David Yuh of the QI Hub, this program is open to clinical and non-clinical BMC mid-level leaders to learn the IHI Model for Improvement and apply QI skills to projects designed to close quality gaps in their departments. DOM Faculty include Drs. David Yuh, Lisa Caruso, Nick Cordella, Shaleen Chakyayil and Ms. Deborah Whalen.
Patient Safety Grants
Each year the BMC Department of QPS awards several Patient Safety Grants of up to $25,000 open to all BMC staff for well-developed QI projects aligned with BMC priorities. Each grant cycle is for one calendar year beginning October 1, 2025. Applications are due September 20, 2025.
Chobanian & Avedisian School of Medicine Student Opportunities
- Dr. Lisa Caruso supports selected second year student LEADS curriculum projects with QI methodology.
- Drs. Lisa Caruso, Nicholas Cordella, David Yuh, Charlie Williams, Cheryl McSweeney and Ms. Emily Jansen teach the pre-third year “boot camp” patient safety module focusing on hospital quality goals and creating a “just culture” in medicine.
- Dr. Lisa Caruso is the faculty director of the popular Quality Improvement 1 and 2 electives for fourth-year medical students.
Opportunities to Showcase Quality Work
- PGY2 End of Year QI Presentations
- Evans Research Day
- BMC’s Patient Safety Week
- National Meetings such as IHI Forum
- Submission to quality journals
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Key Faculty Members
Lisa Caruso, MD, MPH
Clinical Associate Professor
Deborah Whalen, MS
Clinical Associate Professor
Nicholas Cordella, MD, MSc
Assistant Professor
Shaleen Chakyayil, MD
Assistant Professor
David Yuh, MD
Assistant Professor