March 14, 2022
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The Mayo Quality Fellows Program is being improved with criteria for Gold certification to include leading teams for quality improvement, presenting projects at meetings, giving lectures on quality improvement techniques and methodology, and publishing quality improvement work.
When Kannan Ramar, M.D., witnessed a family member suffer because of poor care at another medical facility and a diagnostic error, he had an epiphany.
"This error resulted in delayed management and low-quality care that almost led to (the family member's) death," Dr. Ramar says. "It dawned on me that there were multiple quality and safety gaps in the process of his care."
Dr. Ramar put what he learned from that deeply personal experience into practice and continues to bring that quality focus to his work at Mayo Clinic through the Mayo Quality Fellows Program. Dr. Ramar is passionate about quality improvement. As the former chair of the Mayo Quality Fellows Program, he was instrumental in creating a curriculum that has a positive impact on the care of all Mayo Clinic patients.
The Mayo Quality Fellows program is a certification program offered by the Mayo Clinic Quality Academy. Dr. Ramar cites the Six Sigma business concept and the Define, Measure, Analyze, Improve, Control (DMAIC) framework as integral aspects of the program's curriculum.
"Mayo Clinic Quality Academy offers any Mayo Clinic employee tools and methods to address gaps in quality through improvement methodology training so that others would not have to experience the same ordeal my family went through," Dr. Ramar says.
Three levels of certification
Mayo Quality Fellows certifications are recognized by Mayo Clinic leaders making hiring and promotion decisions. This makes Quality Fellows an attractive option for those looking to differentiate themselves from other qualified candidates.
The Quality Fellows Program offers Bronze, Silver, and Gold certifications that recognize participants at each level of their quality improvement journey.
Bronze certification offers an entry point into quality improvement, while Silver certification allows participants to put what they’ve learned into practice. Gold certification is the most rigorous certification. Participants must demonstrate competence by passing a formal exam, applying what they’ve learned through two approved Gold Quality Improvement Projects, and publishing their findings.
"Gold certification establishes that you have the skills and competencies to do and lead a quality improvement project, and coach others to do QI work. Gold certification is one of the best things that I did," Dr. Ramar says. "My division chair recognized me for this wonderful accomplishment, and it has helped to establish my expertise in leading, performing, coaching, and mentoring others to do quality improvement projects and apply quality improvement tools and methods."
He credits his Gold certification as being instrumental in several career highlights during his time at Mayo Clinic, including his current role as chief patient safety officer and assistant dean of clinical learning environment optimization in Mayo Clinic School of Graduate Medical Education.
"I was sought after by trainees for mentorship on quality improvement projects, providing me an opportunity to teach and mentor on quality and safety for the future workforce," Dr. Ramar says. "The program also helped me meet my board requirements for maintenance of certification."
Dr. Ramar was nominated and awarded the Diamond Quality Fellows Award in 2021 for his exceptional contributions to quality and safety at Mayo Clinic and beyond.
Going Gold to put concepts into practice
Sunanda Kane, M.D., chair of the Mayo Quality Fellows Program Subcommittee, is working through the Gold certification process herself. Her first Gold project was working to improve patient access.
"My personal journey takes me through my research interests which are patient outcomes, and I realized that there is a lot of cross talk between this type of research and quality improvement," Dr. Kane says. "I am also someone who wants to always help be part of the solution rather than just complaining about something, which again lends itself well to root cause analysis and quality improvement."
Her first Gold project dealt with the scheduling of procedures and appointments in Gastroenterology by other departments.
"It came from the dissatisfaction that for common conditions, other Mayo departments referring patients could not just schedule a patient themselves into an open slot on the gastrointestinal calendar," Dr. Kane says. "After thorough analysis, we understood that we needed to use our information technology resources more efficiently to facilitate a better workflow, and ensure that all stakeholders, including other departments, were happy with the solution. We were able to publish our work in a journal as well, which was a great way to finish out the project."
Dr. Kane also credits the DMAIC framework with keeping the project organized and on track. It took more than a year to complete, and cooperation from several departments to test and implement the improvements.
"There were lots of competing opinions and desires that were not necessarily based on the correct data or feasible," she says.
What's ahead for Quality Improvement certification
Nearly 42,000 Mayo Clinic staff are Bronze Fellows, 7,650 are Silver Fellows, and just under 500 are Gold Fellows. Dr. Kane says the process can be cumbersome and confusing for some, which may result in some unintended impact on the integrity of program. That’s why the certification program is currently undergoing an overhaul.
Effective March 1, Silver certification will be required before applying for Gold certification, and enhanced attestation of Quality Improvement knowledge will be required.
"This includes leading teams for quality improvement, presenting projects at meetings, giving lectures on quality improvement techniques and methodology, and publishing quality improvement work," Dr. Kane says.