Chaired by Brijen J. Shah, MD and Daniel I. Steinberg, MD, the Clinical Learning Environment Review Subcommittee unites GME leaders, faculty, residents, and fellows. Together the Subcommittee works to meet the ACGME’s expectations for an optimal clinical learning environment that achieves safe, high-quality patient care in the following domains:

• Patient safety reporting, education, and engagement, including the opportunity to participate in investigations and follow-up
• Professionalism, education and engagement, including resident and faculty perceptions of professionalism, and the establishment of effective policies and procedures for addressing concerns and reports of unprofessional behavior
• Quality improvement education and engagement activities and committees, including initiatives related to health care disparities
• Transitions of care education and engagement, including communications between consult teams and patient transfers between services and locations
• Supervision education and monitoring, including resident and faculty perceptions of adequacy and the roles of clinical staff members other than physicians

Icahn Mount Sinai was one of nine sponsoring institutions nationwide to be selected in late 2018 to participate in the ACGME’s Pathway Leaders Health Care Disparities Collaborative. The selected project was “Use of granular race and ethnicity data (RED) and sexual orientation and gender identity (SOGI) data to assess ambulatory learning environment disparities in process and outcomes of health care.” Icahn Mount Sinai was invited by the ACGME to participate in a third year of the collaborative through the 2020-21 Academic Year.

To continue this work beyond the period of involvement with the ACGME the Health Equity Advancement by Learners (HEAL) Collaborative was established in 2021 with a mission is to provide learners with inspiration, connections, mentorship, an educational platform and the tools they need to address the health care disparities in their areas of expertise.  Emily Hertzberg, MD, and Rui Jiang, MD, serve as faculty advisors for the collaborative.

Residents and fellows are encouraged to apply to join institutional Root Cause Analysis Committees at sites throughout the Mount Sinai Health System. The Root Cause Analysis Committees work to identify the causes of safety events, as part of the Health System’s Serious Adverse Event Process. Committee members receive orientation and training, and are invited to attend 5-10 meetings over the course of the academic year, providing input during case discussions and safety solution meetings.

Reporting of safety concerns by staff is an essential part of a safety culture. As front-line providers, residents and fellows have unique knowledge of the work environment and are highly encouraged to report hazardous conditions, near misses, and adverse events. Reporting is done through an online portal called SafetyNet, which is accessible from any clinical desktop in Mount Sinai Health System. Reporting can be anonymous, and all reports are reviewed within 24 hours by senior leaders across the Health System to determine a plan of action.

This bi-monthly publication profiles Quality and Patient Safety leaders, highlights trainee projects, communicates Mount Sinai Health System quality and safety goals, and provides updates on resident and fellow incident reporting.

The Elective in Patient Safety exposes house staff to Mount Sinai Health System’s Serious Adverse Event process, which works to predict, identify, analyze, and ultimately prevent serious adverse events. Residents will be active participants in debriefs, root cause analyses, and safety solution meetings, and will complete online self-study materials, plus participate in one-on-one meetings with faculty. This elective has been highly reviewed by residents since its launch in 2022. Residents in the elective will work with patient safety experts and explore in-depth learning about patient safety topics.

The Office of Graduate Medical Education and the Continuous Improvement Academy of the Mount Sinai Health System offer the “Level 100: Basic Continuous Improvement” course for faculty and trainees interested in a focused educational opportunity in quality improvement.

Based on Lean and best practice continuous improvement principles, participants are taught the foundational principles of continuous improvement, as well as the expected behaviors and ideas that support the culture of improvement in the Mount Sinai Health System.