In July 2007, the Indiana University medicine residency program joined the prestigious group of twenty-one training programs nationwide who are engaged in the Internal Medicine Education Innovation Project (EIP). Indiana's EIP is entitled Residency Education Advancing and Changing Healthcare (REACH) (see figure). This ten year project provides enough flexibility from the regulations in residency training to creatively redesign the curriculum around what internal medicine requires in the 21st century. It particularly affords an opportunity to improve the healthcare system by fostering inter-professional teams to provide care and will focus on safe, patient-centered coordinated care over time for every patient from inpatient to outpatient, specialist to primary care.

The IUSM EIP - REACH project includes three initiatives:

Patients First will develop the continuity clinic curriculum to improve the capacity for faculty and residents to provide improved patient-centered, quality longitudinal care that promotes wellness and focuses on chronic disease management using multidisciplinary teams.

Leading Change works to define and instill leadership qualities in our residents while simultaneously encouraging ownership of the residency program and the patient care it delivers. In addition, it will further cultivate all the necessary skills for fostering healthcare systems change for quality and patient safety improvement.

Patients Safe is a curriculum designed to engage residents in delivering highly reliable healthcare. It will teach not only the key concepts of patient safety but additionally work toward changing the systems to prevent harm focusing on the handoff of patient care from one provider/team to another and the transition of patients from the inpatient to outpatient setting.

Planned Innovations

1. Micro-system clinic team building with one-week continuity clinic immersions interspersed over 3-year curriculum
2. Customization of components of the curriculum to achieve individual resident’s career goals
3. Progressive expansion of quality improvement teams across campus
4. Quarterly "report cards" analyzing patient outcomes of each resident's patient panel
5. Team-based learning of core curriculum and skills in collaboration
6. Semi-annual collection of patient satisfaction information
7. On-line modules for competence in ECG interpretation, patient safety concepts, and periodic self-assessment of learning
8. Opportunities to work one-on-one with distinguished faculty while mentoring them around quality improvement projects in faculty practice sites
9. Simulation of procedures and codes
10. Participation on key committees to inform leadership of resident point of view in decision making.

We are looking for applicants who want to make a difference in health care. IU trainees will become active contributors in the patient care and residency improvement process. We strive for our graduates to make substantial contributions large and small to medicine and delivery of quality healthcare.