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Quality improvement (QI) isn’t something that comes immediately to mind when students and young physicians think about how they can make a difference in the world of medicine. But that’s not the case with Jenna Smith-Forrester, a fourth-year student in the University of British Columbia’s Northern Medical Program. She has made it her mission to advocate for – and help the medical community better understand – the principles of Quality Improvement. And it has already resulted in big changes for one of Canada’s most prominent medical schools.
Jenna credits a volunteer-based trip to Honduras with the Mayo Clinic Medical School for helping her recognize her own potential for catalyzing change. The leaders of the trip had a unique way of bringing their team together and enhancing communication: a simple cue card exercise that team members did every morning. “I was amazed that something as simple as cue cards were able to get 60 people working together effectively over the course of a single week. The camaraderie and sense of altruism the exercise generated was inspiring.”
After that trip, Jenna completed online training offered through the Institute for Healthcare Improvement’s (IHI) Open School, learning as much as she could around Quality Improvement methodology. When Jenna started her medical training at UBC, she brought some of that vision – and the confidence to enact it – with her. How could she apply those principles and capitalize on the enthusiasm of new medical students to get them interested in Quality Improvement?
“Most people know the term Quality Improvement, but they don’t have a good sense of what it really means,” Jenna says. “It’s become a buzzword. While many people think of it in the context of research, it really should be thought of as a framework to improve your daily work activities: a way to identify, measure, and implement changes in rapid, incremental cycles with the aim of creating a more efficient, streamlined system that reduces redundancy and waste. And in the world of health care, that can make a life-or-death difference.”
Jenna wanted to help medical professionals, and particularly medical trainees, reframe their thinking around QI. She began to advocate for introducing IHI’s Quality Improvement training into the UBC curriculum. “When you’re in your clinical years, you’re so overwhelmed,” Smith-Forrester says, “you’re not thinking about how to do things better, but how you’re going to do them at all.” She knew that introducing the foundational principles of QI in the first or second year of medical training would give students new tools to solve problems. “QI isn’t simply another skill to learn or process to memorize—it’s a new way to approach the training itself. It’s almost philosophical, and the impact will influence your approach not only to problems and processes within medicine, but even in your everyday activities”
Jenna introduced her fellow students to resources from the Institute for Healthcare Improvement (IHI), brought in QI experts, led detailed discussions of where and how it was relevant to their current level of training—and where it would be relevant in their future careers. In her second year of medical school, she served as one of the main organizers and hosts of a national conference, Health Innovation for All, that united all 21 Canadian chapters of IHI’s Open School and put the spotlight on student-led QI efforts. This event alone united over 400 student and professional attendees from across the health disciplines, strengthening local, provincial and national QI networks. The feedback of her collective efforts has been so overwhelmingly positive that she was able to put forth a case for making IHI’s QI training mandatory in UBC’s Medical Program.
Looking forward to residency, Jenna is pursuing a career in the clinical neurosciences where she can bring together her passions for QI, patient care, and systems level thinking. As she continues to study and advocate, she’s living up to the wise words of Dr. Don Berwick, one of the most recognized names in QI and the founder of IHI: “Everyone has two jobs: doing it and improving it.”
Jenna Smith-Forrester is a fourth year medical student in the University of British Columbia’s (UBC) Northern Medical Program in Prince George, British Columbia. She has completed a BSc in Neuroscience at Dalhousie University and an MSc in Clinical Neuroscience from UBC. Throughout her education she has lived in the USA and Australia. She held a Research Scholar position at the Mayo Clinic in Rochester, MN; and since 2013 has worked extensively with the leadership teams at the Institute for Healthcare Improvement based in Cambridge, MA. She enjoys traveling with her husband to destinations no one has ever heard of, long hikes, and jumping out of planes. She is a proud dog mom, who over indulges in spoiling her two chocolate labs.
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