Linking health professional learners and health care workers on action-based improvement teams.

BACKGROUND AND METHODS: Medical students, nursing students, and other health care professionals in training were integrated with health care workers on interprofessional quality improvement (QI) teams at our academic health center. Teams received training in QI, accompanied by expert QI mentoring, with dual goals of increasing expertise in improvement while improving care. RESULTS: Eighty-six learners and health system workers participated in 12 improvement teams in 2 years. Upon completion of the training, participants expressed that the program enhanced QI and teamwork skills and increased understanding of other health care professions. At the end of the program, fourth-year medical students showed greater ability to apply QI skills, as measured by the QI Knowledge Assessment Tool than did control students who did not participate in the program (P < .0001 in 2006-2007 and P < .0005 in 2007-2008). Many teams were successful in improving care processes. CONCLUSION: The design of "learning QI by doing," accompanied by just-in-time training and ongoing expert mentoring in QI, was identified by faculty as the most important factor contributing to success. This model successfully improved application of QI skills by learners while improving care within our academic health center. Testing of the model at other academic health centers and in other training environments is warranted.

Removing service barriers for women with physical disabilities: promoting accessibility in the gynecologic care setting.

Although women with disabilities constitute a substantial segment of the population, their gynecologic health care needs often go unrecognized or untreated. Women with disabilities encounter a variety of obstacles to receiving health services including attitudinal, environmental, economic, and informational barriers. Standard screening and preventive services, such as pelvic examinations and mammograms, can be especially difficult to obtain, potentially placing women with disabilities at greater risk for diseases such as breast cancer and cervical cancer. This article reviews the current status of gynecologic care for women with disabilities and provides strategies for women's health care providers seeking to increase the accessibility of their practice settings.