Aligning institutional priorities: Engaging house staff in a quality improvement and safety initiative to fulfill Clinical Learning Environment Review objectives and electronic medical record Meaningful Use requirements

Meghan R. Flanagan*, Carolyn C. Foster, Anneliese Schleyer, Gene N. Peterson, Samuel P. Mandell, Kristina E. Rudd, Byron D. Joyner, Thomas H. Payne

*Corresponding author for this work

Research output: Contribution to journalArticle

2 Scopus citations


Background House staff quality improvement projects are often not aligned with training institution priorities. House staff are the primary users of inpatient problem lists in academic medical centers, and list maintenance has significant patient safety and financial implications. Improvement of the problem list is an important objective for hospitals with electronic health records under the Meaningful Use program. Methods House staff surveys were used to create an electronic problem list manager (PLM) tool enabling efficient problem list updating. Number of new problems added and house staff perceptions of the problem list were compared before and after PLM intervention. Results The PLM was used by 654 house staff after release. Surveys demonstrated increased problem list updating (P =.002; response rate 47%). Mean new problems added per day increased from 64 pre-PLM to 125 post-PLM (P <.001). Conclusions This innovative project serves as a model for successful engagement of house staff in institutional quality and safety initiatives with tangible institutional benefits.

Original languageEnglish (US)
Pages (from-to)390-397
Number of pages8
JournalAmerican Journal of Surgery
Issue number2
StatePublished - Feb 1 2016



  • Clinical Learning Environment Review
  • Electronic medical record
  • House staff
  • Inpatient problem list
  • Meaningful Use
  • Quality improvement

ASJC Scopus subject areas

  • Surgery

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