I. Background and Overview of Program
The Harvard Medical School Master of Healthcare Quality and Safety (MHQS) program provides world-class instruction and training aimed at preparing clinicians to work effectively in and lead quality improvement and safety initiatives.
Designed to accelerate the learning and development process, this degree program combines theory and research with unparalleled exposure to best practices and research from Harvard's network of practitioners
The carefully designed curriculum encompasses five key areas: operational quality and safety, informatics, leadership, quantitative approaches, and risk culminating with a capstone experience in which students develop a solution to an evidence-based healthcare delivery issue. Working alongside a professional mentor, students will apply the tools, strategies, and methods from didactic courses to address a challenge that aligns with their goals and interests.
Mission Statement and Goals and Objectives
MHQS provides outstanding didactic instruction and mentorship to healthcare professionals to prepare them for leadership roles in patient-oriented safety and quality improvement.
The major goal of the program is to provide an innovative comprehensive curriculum that allows participants to pair knowledge and skills with practical experience. The learning model builds upon theoretical knowledge of healthcare quality and safety and expands to include practical applications to assess and improve processes of care. With the opportunity to gain experiential knowledge, students will be well poised to take on leadership and management initiatives.
Program Objectives
LEADERSHIP DEVELOPMENT
• Describe how to drive change and foster a culture of quality and safety
• Develop students’ confidence to lead teams of professionals who engage in improvement work
• Expand individual capability to become an effective leader in the field of quality and safety
ANALYTICS/INFORMATICS
• Generate data-driven solutions that address operational challenges
• Learn to measure, interpret, and communicate meaningful outcomes of quality and safety data, initiatives, and research
• Use data to support rational and evidence-based improvements
HEALTHCARE QUALITY
• Deepen understanding of evidence-based patient-centered approaches to improving care
• Identify quality and safety gaps, and develop strategies for addressing them
• Construct and interpret meaningful outcomes from quality and safety initiatives
PATIENT SAFETY
• Develop an innovative infrastructure for healthcare delivery that improves safety
• Assess and improve processes of care through evidence-based best practices
• Identify, design, and implement malpractice prevention and intervention strategies
Upon completion of the program, graduates will be equipped to obtain leadership roles such as Director of Patient Safety, Assistant or Associate Quality Officer, Director of Patient Relations and Risk for departments and institutions. Furthermore, graduates from this program will be prepared for chief medical officer and/or chief quality officer positions as their careers advance.
Online Modality Considerations
Due to the COVID-19 pandemic, the MHQS program transitioned to an online delivery modality for the 2020-2021 academic year. This transition enabled us to critically assess each course’s teaching and evaluation methods and how these would translate to an online environment. In subsequent years after the transition to online, each course was reviewed to ensure that the learning objectives of the course were maintained and that the quality of instruction was preserved. We created a guide entitled “The 7 Step Approach for Course Migration to Online Learning” to facilitate this process:
1. MHQS leadership team had an initial meeting with each individual course director and teaching assistant to discuss the transition and logistics
2. Course directors were asked to look at their curriculum and identify the broad archetype and themes of the course. The themes were used to begin discussion of instructional tools needed and the curriculum map
3. Course directors were given examples of the types of educational activities they could select from (both synchronously and asynchronously) and asked to determine which tools could best support the desired learning outcomes
4. Course directors defined a course outline and curriculum map. These contain specific information about content, hours spent on the content, and the distinction between synchronous and asynchronous delivery
5. With the specific content identified, a production plan was developed. Production needs included video recording, integration of interactive questions, and video production.
6. Course directors completed the final syllabus and worked with PGME to create the course Canvas sites. The sites were developed to support the learning objectives of the course and make the content accessible in a fully online learning modality
7. Course directors were asked to consider how the course will be evaluated given the transition to online learning.
For the 2024-2025 academic year, we plan to follow this approach and work closely with the course directors to fine tune their courses based on their experience and prior evaluations. We plan to build on the course materials we have already developed and further define learning objectives and teaching tools. Please see appendix A for an example of a course transfer from in residence to an online format.
Critical Elements of Curriculum Design
As the program transitioned to online instruction, the foundational principles of the residential program’s original design were maintained:
• Cutting edge evidence-based curricular content for operational leaders that is the same as the in residence MHQS degree
• Opportunity to work with and learn from HMS faculty
• Opportunities for experiential learning and skills-based training
• Offerings that support learners' development of a network, both within their institution and HMS
• Course offerings that are academically rigorous and comprise a holistic perspective of healthcare quality and safety
Course Workload Distribution
With consideration to HMS policies around credit hour distribution, we recommend the following range of weekly course hours based on course credits inclusive of synchronous and asynchronous material with an approximate 1:3 ratio:
These hours are consistent with the hours we would expect students in the residential program to devote to in person class time and assignments outside of class.
Program Outline / Courses
The core MHQS program (Quality and Safety pathway) is organized as follows:
1. An introductory course entitled “Fundamental Skills for Academic Success” to begin the program in July. The primary objective of this course is to prepare students for work in the master's program and set expectations for managing time, academic integrity, and tips for success in the program. This course also begins the process of establishing our community with student-derived shared goals, values and behavioral expectations
2. A Safety Intensive course for three weeks in July to introduce students to the fundamentals of quality and safety and orient them to the QI tools that will be used throughout the program
3. After framing the current state of safety and quality, the fall term commences with prerequisite learning modules to employ critical QI tools and understand the power of data. Students focus on quantitative approaches to assessing outcomes specific to QI research. This is achieved through a course in Quality and Systems and the Quantitative Approach to QI course.
4. A course in Financial Planning and Management is offered in the fall semester to provide a framework for finance models and to contextualize the tools and resources needed to run effective organizations
5. Informatics for the Quality and Safety Leader is offered in the fall semester to provide MHQS students with a broad introduction to the ecosystem of data related to health care. It is a seminar designed to help students succeed at the intersection between information systems, clinical work, and quality and safety.
6. To support mentored QI work more centrally and allow for peer mentorship, students will participate in two “Longitudinal Seminars in QI” courses- one in the fall term and one in the spring in the full-time track Students will be divided into small groups and paired with a faculty QI coach. These groups meet multiple times per
term in order to enable students to develop their projects with peer feedback. Specific frames for developing and documenting capstone work are designed to support these two seminars with specific milestones. The fall seminar will focus on reviewing the framework for project work.
7. The J-Term consists of Risk and Evidence Based Interventions and a course in Leadership and Teamwork. These courses will also help provide context for the Applied QI and Safety course in the Spring term by orienting students to focus on applied skills and effectively utilizing the foundational knowledge acquired during the fall semester.
8. In the Applied QI and Safety course offered in the spring term, students will build on theoretical concepts developed in the fall term and examine applications of best practices from the perspective of a major academic system.
9. The Patient Engagement course will review key and emerging concepts in QI and safety as they relate to patient-provider and patient-system interfaces.
10. Integrating New Technology into Healthcare Delivery is meant to provide students with more applications of tools to facilitate healthcare delivery. Students may elect to take this course if there are interested in additional training in informatics and technology use in healthcare. Students have the choice to take this course OR a course in QI Education training
11. In the second year spring term, students are given the option to select a “special topics” course which aligns with their personal interests. The topics offered are medication safety & diagnostic error and healthcare equity. Students may select which elective they are interested in.
12. The Spring Longitudinal Seminar will begin with a designed implementation plan. Students will reflect and be coached on the process of implementation with lessons in navigating change in healthcare. This seminar will conclude with a capstone symposium where candidates will briefly present both their projects and their reflections as learners.
13. Each student is required to complete a capstone project as part of the master's program. The experience allows students to apply the tools, strategies, and methods from their didactic courses to develop a solution to an evidence-based problem seen in healthcare delivery. This problem could be driven by a need in Quality, Safety, Informatics, or Risk. Students are paired with a mentor from within a healthcare organization to oversee the work, as well as an HMS coach. Successful completion of the capstone will be based on assessment of completed milestones, a comprehensive written report, and an oral presentation
14. Elective course opportunities at HMS and other Harvard schools are available with the permission of the Program Director.
** Please note that the sequencing described above is for the full-time student in the Quality and Safety pathway. For part-time students this sequencing is identical, with the core courses offered in the first year, and the advanced and contextual courses offered in the second year. The Longitudinal Seminars are offered in Spring I and Fall II. Please see the curriculum maps below for details.
Pathway Options
A pathway in Clinical Informatics is offered within the MHQS program. This pathway is ideal for students who are interested in how the design of electronic systems and infrastructure can support improvements in safety and quality in their work and organization.
This pathway provides students with the tools to be able to function as leaders and guide their decision making related to informatics. Within the traditional program, students who satisfy foundational knowledge prerequisites in information systems can register for courses that address core functions of information systems as they function within health care organizations. Students will explore the importance of the interface with frontline clinical providers, and strategies in acquiring the appropriate clinical data to answer quality and safety questions. In addition, students will complete a capstone project related to medical informatics.
The objectives of the informatics pathway are to:
• Identify which elements of information systems can be leveraged to improve the quality and safety of healthcare. This will be achieved by recognizing the fundamental role and list of integrated functions that information systems provide to support the delivery of care.
• Develop skills to perform a gap analysis around information system needs and strategies to address these needs. This will be achieved through the application of a framework to gather data and reflect on demands, recognition of how to assess strengths of different applications and systems, and matching demands to feasible solutions.
• Develop skills to lead and guide frontline providers as they make the argument for change in the electronic environment. This will be achieved through an operational understanding of the health informatics field in course work combined with the expert knowledge of frontline workflow and how the combination is necessary to have a measurable impact on quality outcomes and patient safety.
Students who complete this pathway will be positioned to attain positions such as Director of Medical Informatics, Director of Nursing Informatics, Director of Physician Engagement, Digital Health Officer, Chief Medical Information Officer.
Courses within the Clinical Informatics Pathway include:
• HQS 707: Bioinformatics and Clinical Quality (3 cr)
• HQS 716: Practical Topics in Medical Informatics (2 cr)
II. Degree Offered
A Master of Science degree will be awarded. This 36-credit program consists of academic training, mentored training, team-based projects and career-development activities. A part time option is offered for students who wish to complete their credits over the duration of two years. Decisions to move to full time vs part time status are made at acceptance and matriculation and are approved by the Program Director. Full-
time and part-time participation are subject to successful completion of courses to date and the capacity of each track within the program.
III. Prerequisites for Admission
Applicants must hold an MD, MBBS, or an equivalent doctoral degree from other disciplines Applicants who hold a master's or PhD degree will be considered on a caseby-case basis for admission to the program. Applicants must have at least two years of post-graduate experience. Eligible doctoral degrees include, but are not limited to, the following: D.D.S., D.M.D., D.O., M.B.B.S., and M.B.Ch.B.
A language proficiency test is required for applicants for whom English was not the medium of instruction for their undergraduate or graduate degree. Harvard Medical School's master’s programs accept TOEFL iBT, TOEFL Essentials, IELTS Academic and Duolingo English Test. English language proficiency tests are only valid for two years after the test date.
Applicants must score a minimum of 103 (TOEFL iBT), 7.5 (IELTS Academic), 11 (TOEFL Essentials), or 125 and satisfactory programmatic review of the writing and video samples (Duolingo English Test) to be considered for the program.
IV. Academic Residence Requirements
The MHQS program has received a residency waiver for 2024-2025. This waiver allows didactic coursework and mentored research to take place outside of HMS and in the online environment. However, it is expected that students will attend synchronous classes via Zoom and meet the standards of participation outlined for each course. Furthermore, students are required to identify a mentor at their home capstone site who will oversee the project and be in communication with the student and the student’s capstone committee. Instruction will be provided via 16 courses across two semesters for full-time students and 16 courses across four semesters for part-time students. Each track will complete a minimum of 36 credits.
V. Course of Study
Concentrations offered
• Clinical Informatics Pathway
• Quality and Safety Pathway
Curriculum by term
• The program begins in July 2024 and ends in May of 2025 for full-time students. The program begins in July 2024 and ends in May of 2026 for part-time students.
Full Time and Part time options
• Full time students in the Quality and Safety pathway will complete 5 credits in the summer, 15 credits in the Fall semester, 5 credits in the J-term, and 13 credits in the Spring.
• Full time students in the Clinical Informatics pathway will complete 5 credits in the summer, 14 credits in the Fall semester, 5 credits in the J-term, and 14 credits in the Spring.
• Part time students in the Quality and Safety pathway will complete 21 credits in the first year (5 in the summer, 7 in the Fall, 2 in J-term, and 7 in the Spring), and 17 credits in the second year (8 in the Fall, 3 in J-term, and 6 in the Spring).
• Part time students in the Clinical Informatics pathway will complete 21 credits in the first year (5 in the summer, 7 in the Fall, 2 in J-term, and 7 in the Spring), and 17 credits in the second year (7 in the Fall, 3 in J-term, and 7 in the Spring).
Summary of Changes for AY 2024/2025
• QI Education Training will move from 1 to 2 credits
• QI Education Training will run concurrently to Integrating Healthcare Technology. Students will select one course or the other to satisfy this requirement
• Part-time year 2 students enrolled in the Quality and Safety pathway will be given the option to take HQS 707: Bioinformatics and Clinical Quality (3 cr) in lieu of HQS 710: Informatics for the Quality and Safety Leader (1 cr.) as long as they do not exceed 13 credits in any semester (barring the course has capacity)
Summary of Changes from Residential to Online Delivery
• Additional asynchronous material has been introduced to support student learning and reduce cognitive load in the online synchronous environment.
o Materials include pre-recorded videos, discussion boards, interactive modules, and group work
• Additional student touchpoints have been incorporated into the program, including additional 1:1 meetings with the program directors and course directors, as well as office hour offerings. The HMS capstone mentor also closely monitors the students’ project and provides feedback throughout the duration of the project. These touchpoints were increased in the online program to allow for more opportunities to connect with students and monitor their progress in the program
• The capstone project was re-designed to support completion at the students’ home institutions, rather than an HMS affiliated hospital. This allows for greater flexibility in projects and opportunities to continue the work after graduation from HMS. New milestones and role agreements were introduced for the online program so that the project could be closely monitored and evaluated as it developed. Rubrics are now shared with students to better facilitate their learning and planning of projects themselves.
Full time curriculum map
Course Sequencing
(Courses in blue are part of the Clinical Informatics pathway)
Summer Term (July)
HQS 742: Fundamental Skills for Academic Success (1)
HQS 700: Safety Intensive (4)
Fall Term (Sept-Dec)
HQS 701: Quality and Systems (4)
HQS 703: Quantitative Approach to QI (3)
HQS 715: Longitudinal Seminar I (full-time) (1)
HQS 726: Longitudinal Seminar II (part-time) (1)
HQS 717: Capstone (3)
HQS 712: Healthcare Finance and Value (3)
HQS 710: Informatics for the Quality and Safety Leader (1)
HQS 707: Bioinformatics and Clinical Quality (3)
January Term
HQS 711: Risk and Evidence-Based Intervention (3)
CI 740: Leadership and Teamwork (2)
Spring Term (Feb-May)
HQS 702: Applied Quality and Safety in Healthcare Settings (4)
CSO 708: Integrating New Technology into Healthcare Delivery (2)
HQS 705: Patient Engagement in QI and Safety (2)
HQS 706: Medication Safety & Diagnostic Error (1)
HQS 728: QI Education Training (2)
HQS 730: Integrating Quality, Safety, & Healthcare Equity (1)
HQS 716: Longitudinal Seminar II (full-time) (1)
HQS 725: Longitudinal Seminar I (part-time) (1)
HQS 718: Capstone (3)
HQS 714: Practical Topics in Medical Informatics (2)
VI. Course Descriptions
HQS 742: Fundamental Skills for Academic Success
(Course Director: Anjala Tess, MD)
This course is designed to give students an overview of some of the key skills that will support their experience as graduate students. We will review how we can learn more effectively and why having a growth mindset is essential in graduate school and professional life. Students will analyze and discuss key challenges in professionalism (communication, respect, biases, academic honesty, etc.). Furthermore, we will focus on building and strengthening essential leadership and teamwork skills like perspective taking, contribution to group dynamics, and best practices when working in groups.
Building on organizational behavior and coaching principles, this course will also examine key aspects of leadership from the inside out. The class will discuss project management as a graduate student and relationship building with a key focus on mentor-mentee relationships. Finally, students will evaluate their strengths and weaknesses regarding professionalism, teamwork, and leadership, and develop a strategy to enhance their academic and professional performance.
HQS 700: Safety Intensive
(Course Director: Anjala Tess, MD)
The Safety Intensive provides students with a foundation in patient safety. Beginning with the question, “Are we any safer than twenty years ago?” students explore the state of healthcare today. Fundamental concepts in safety follow including the interplay of culture, human factors, and system theory as critical components of safety science. Special areas of focus are discussed including procedural safety, ambulatory safety, and teamwork. Sessions will include interactive didactics, small group work, and weekly assignments. Assessment will include a combination of class participation, quizzes, and written work.
HQS 710: Informatics for the Quality and Safety Leader
(Course Director: Saurabha Bhatnagar, MD)
Informatics for the Quality and Safety Leader provides MHQS students with a broad introduction to the ecosystem of data and technology related to health care. It is designed to orient students to the intersection between information systems, clinical work, quality and patient safety. The course will explore critical elements of information systems, including operational technology functions, data infrastructure, governance, and electronic health record (EHR) design. Additionally, there will be an overview of the explosion of healthcare technology and how it relates to healthcare operations, and the potential promise it holds for quality and safety (and potentially outcomes-based care and high-reliability loops). Asynchronous course work will focus on foundational elements with seminar time focused mainly on application. Assessment will include a combination of class participation and written work. Sessions will include interactive seminars and preexisting asynchronous module work. Assessment will include a
combination of class participation, written work, and quizzes. Pre-class work is clearly delineated and is mandatory for effective class participation
HQS 703: A Quantitative Approach to Quality
(Course Directors: Shoshana Herzig, MD, Dionne Graham, PhD)
This course prepares students to apply quantitative methods to ongoing QI work. Students will learn frameworks to pose study questions and select appropriate analytic methods. Didactics will focus on statistical methods that will allow them to analyze simple data and present their findings. Learners will learn how to assess outcomes specific to QI research. Learners will also begin to discuss general IRB issues.
HQS 712: Healthcare Finance and Value
(Course Director: Kae Santos, MBA, Laura DeSisto, MBA)
The Healthcare Finance and Value course is designed to expose you to financial management concepts and uses. The sessions are devoted to the development of a basic knowledge of cost accounting, differential analysis, and alternative decision making. The course places particular emphasis on the practical application of the concepts covered in health care settings.
Because health care institutions have lagged far behind industry in understanding their costs, there is a pressing need for people who are familiar with those concepts in managerial, operational, quality and policy settings. The goal of this course is to provide that basic familiarity.
HQS
701: Quality and Systems
(Course Director: Brittany Esty, MD, MPH, Julia Finkelstein, MD, MPH)
After framing the current state of quality in a historical perspective, this course emphasizes concepts, methods and skills required for quality improvement (QI). The course will provide a comprehensive exploration of QI methodology. Students will be able to compare and contrast QI methodology and employ critical QI tools. This will be learned through a combination of didactic presentations, case-based application, exercises, and a personal improvement project. The class will help provide foundational understanding of measurement and the power of data. Students will also learn to formulate, design, and implement change within the health care setting and also within personal improvement projects. Students will collect and share data in the context of real improvement work. In doing so, the class will provide core components necessary to lead quality improvement projects to make a lasting impact in healthcare.
HQS
707: Bioinformatics and Clinical Quality
(Course Directors Hannah Galvin MD, Brian Herrick MD)
This course provides a detailed overview of clinical informatics for professionals who will work at the interface of clinical care and the healthcare system. Students will be introduced to the basics of data infrastructure and operational systems, and will learn how information is stored, accessed and integrated across hospitals, physician offices, and other healthcare settings. The
evolution of the electronic health record and its use to promote patient care that is safe, efficient, effective, timely, patient-centered and equitable will be discussed. Students will also study implementation failures and unintended consequences on systems. Students will learn the mechanics of data requests to support quality improvement and redesign.
HQS 715: Longitudinal Seminar Series I (full-time)
(Course Directors Anjala Tess MD & Bijay Archarya, MD)
Full time students in their first semester are to enroll into the first component of the Longitudinal Seminar Series. This course is designed to support mentored QI work more centrally and allow for peer mentorship and individualized coaching. Working in small groups, students will meet periodically throughout the semester to develop their capstone projects with peer feedback. Specific frames for developing and documenting capstone work will be designed to support this course with specific milestones. The fall seminar will focus on reviewing the framework for project work. Students will be expected to define the problem within the organization using QI tools such as mapping, fishbone diagrams, and key driver diagrams, as well as input from local stakeholders. Interventions will be proposed by end along with a projected implementation plan. Students will be asked to reflect on the process of moving from problem to design.
HQS
726: Longitudinal Seminar Series II (part-time)
(Course Directors Brittany Esty, MD, Kae Santos, MBA, Marc Pimentel, MD, Joe Jacobson, MD, Jefferey Durney, MD, Claire Massero, MS)
Part time students in their second year are to enroll into the second component of the Longitudinal Seminar Series. This course is designed to support mentored QI work more centrally and allow for peer mentorship and individualized coaching. Working in small groups, students will meet periodically throughout the semester to develop their capstone projects with peer feedback. Specific frames for developing and documenting capstone work will be designed to support this course with specific milestones. The second seminar will begin with an implementation plan. Students will reflect and be coached on the process of implementation with lessons in navigating change in a healthcare unit. This seminar will conclude with a capstone symposium where candidates will briefly present both their projects and their reflections as learners.
HQS 717: Capstone I
(Course Directors: Anjala Tess MD; Brittany Esty, MD, MPH Kae Santos, MBA)
Students in the MHQS program will complete an experiential capstone experience within the master’s program. This project will demonstrate the progressive achievement of the key competencies required for an MHQS student. Students will be asked to apply the tools, strategies, and methods from their didactic courses to develop a solution to an evidence-based problem seen in healthcare delivery. Each student will be paired with a mentor within a healthcare organization, and together they will select a specific problem driven by a need in quality, safety, informatics, or risk within the organization.
Successful completion of the capstone will be based on an assessment of a written paper that should be 15-18 pages long, including a comprehensive description of the process and steps performed as part of the experience. These modules provide students and mentors with essential information about how to prepare and submit the capstone experience manuscript in a format acceptable to Harvard Medical School.
HQS 711: Risk and Evidence-Based Intervention
(Course Director: Luke Sato, MD)
Risk management has become a reality of US healthcare practice today. Malpractice claims can have a major impact for patients, providers, and organizations. This course provides an overview of the malpractice system and recent evolution in the field including the role of apology and disclosure. CRICO is the malpractice liability carrier for Harvard Medical Institutions and regularly uses its malpractice claims database to identify needs within patient safety. The course will describe innovations and interventions that have come from these areas of risk, including the diagnostic process, communication failures, procedural safety, and medication safety. Strategies will be shared and course leaders will reflect on the importance of consensus and partnership.
CI 740: Leadership and Teamwork
(Course Director: Ajay Singh, MBA, MBBS, FRCP, Christopher Fortier, PharmD, FASHP, Martin Pusic, MD, Ph.)
This course examines different aspects of working with, managing, and leading a team. Lectures will discuss the skills and techniques that are needed to manage a talented group of people effectively, pilot successful collaborations within and outside a group, navigate the complexities of the institution, and manage the inevitable conflicts that arise in a high-stakes environment.
HQS 702: Applied Quality and Safety in Healthcare Settings
(Course Director: Elizabeth Mort, MD, MPH Lisa Heard, DNPc, MSN, RN, CPPS, CPHQ)
This course will expose the learners to the opportunities and challenges associated with applying quality and safety tools in practice. The scope of the applications addressed will include individual quality improvement projects as well as large scale implementations. Learners will be exposed to the institution and system-wide improvement activities and, importantly, understand how core quality and safety functions are critical to supporting these applications. Sessions will largely be led by senior members of the Lawrence Center for Quality and Safety at MGH who are both content experts and scholars and who also have operational responsibility for the delivery of results.
The course will build on the fundamental teachings of theory introduced in the master's program to date and give real-world examples of how theory is translated into practice. While many examples will be hospital-based, improvement in the ambulatory sector and patient experience will also be addressed. Learners will be actively encouraged to work through examples and reflect on how the examples used in the course relate to their own experience and areas of responsibility. Issues of governance and organizational structure, management incentives will be
addressed throughout the course to provide the learners with tangible examples of the ways in which strong leadership and management can accelerate improvement.
CSO 708: Integrating New Technology into Healthcare Delivery
(Course
Director: Trung Do, Assistant Course Directors Karen Piatt, Dimple Kothari)
Technological advances in healthcare are moving at a rapid pace. Digital health is serving as a critical strategic enabler that allows data to be transformed, enterprise wide and locally, into rich insights that enable improved care outcomes, exceptional patient experience, workflow efficiencies, and greater system cohesion and operational alignment. The convergence of big data, artificial intelligence (AI), cloud computing and the internet of things (IoT) has served as a disruptive force across industries and is now propelling innovation in healthcare. The implementation of these technologies in healthcare is introducing new methods for care delivery and challenging the status quo across the spectrum of hospital operations, from back-end administrative functions to front-line patient care.
This course will explore factors driving the need for innovation in healthcare today, the benefits and risks of adopting new technology, and methods for creating and capturing value (e.g. commercialization). The course will provide clinical operations leaders with strategies for evaluating opportunities, conducting due diligence (e.g. financial and operational) and decision making. Additionally, students will learn methods to implement in-house and/or vendor developed solutions into clinical and administrative workflows and how to scale those solutions across complex matrix organizations.
HQS 705: Patient Engagement in QI and Safety
(Course Director: Patricia Folcarelli, RN, MA PhD, Maren Batalden, MD, MPH)
This course highlights the patient interface with the healthcare system and provides a unique perspective to healthcare professionals engaged in safety and quality improvement. The quality and safety movement has employed many tools that emerge from the world of manufacturing. As a “service” industry, health and healthcare outcomes are not produced by healthcare professionals alone, but are inevitably co-produced by healthcare professionals working in partnership with patients and family. The character of that partnership is critical to producing safe, high quality, high value outcomes. In this course, we explore the nature of this partnership and the importance of engaging patients effectively in our efforts to improve quality and safety. Using a framework articulated by Charles Vincent and Rene Amalberti, we consider quality of care on a spectrum from very poor care in which harm results (the domain of concern for patient safety) to excellent care in which evidence-based practices are employed and patients are treated with respect and compassion (the domain of quality and patient experience). In this course, we explore opportunities and strategies for partnership all along that spectrum from the reporting of adverse events to the design and implementation of improvement endeavors to the measurement and innovation related to patient experience and empowerment.
HQS 706: Medication Safety & Diagnostic Error
(Course Director: Gordon Schiff, MD)
Safety and quality operations are continuing to evolve as the field grows. This course will present in an in depth look at several special topics in a number of key emerging fields. It will focus especially on 2 emerging patient safety fields diagnostic errors and medication safety and will be led by an international expert in these areas. It will also cover key areas and controversies related to primary care, professional patient boundaries, health reform and quality, and the past and future of the patient safety movement. Finally, the course will give you the opportunity to meet and question several major thinkers and leaders in the field of quality and safety. Sessions will emphasize interactive didactics in a seminar format to create memorable, enjoyable, and high-level learning. Assessment will include a combination of in-class participation and effort, and timely and thoughtful written reflections. For the Diagnosis and Medication safety modules you receive and gain experience using new toolkits developed for this course that will help you create safer practices and understandings in these critical safety areas.
HQS 728: QI Education Training
(Course Director: Anjala Tess, MD)
Safety and quality operations are continuing to evolve as the field grows. This course will present special topics on quality and safety Education training. Workforce development and training others in quality and safety has become an important part of quality improvement within organizations for several reasons. It can be a useful way to build culture within an organization. It is an important way to grow the teams necessary to sustain QI and safety work. It has recently become a core requirement of graduate training and therefore important for faculty development as well. All of this training often falls to the operational leaders because they have the most experience. However most operational leaders have no training in how to teach. In this seminar style series, we will review some basic principles and skills in medical education along with an approach to curriculum development. We will review specific skills that are useful in QI and safety education including teaching root cause analysis, coaching QI projects, and running M&M conferences. The sessions will conclude with a discussion of students’ designs of their own teaching sessions.
HQS 730: Integrating Quality, Safety, and Health Equity
(Course Directors: Nadia Huancahuari, MD, Esteban Gershanik, MD, MPH, MSc)
Safety and quality operations are continuing to evolve as the field grows. This course will present special topics in health equity. The IOM dimensions of quality has the term “equitable” listed, yet equity has received little consideration. This is despite the quality agenda has grown in the last twenty years. Though healthcare disparities have been discussed and recognized, much of this work does not take into account the role of societal structures, history, and their impact on outcomes. Recent attention to the impact of structural racism and social determinants on health outcomes provides an opportunity to explore issues of equity in healthcare quality. Specifically, we can now better address equity as part of our safety and quality work by learning new ways of
thinking and doing. In a seminar style series given by HMS expert faculty, we will review key aspects of this topic including how to adopt new narratives, manage data infrastructure, and incorporate questions of bias into reporting and review of safety events.
HQS 716:
Longitudinal Seminar Series II (full-time)
(Course Directors Anjala Tess MD & Bijay Archarya, MD)
Full time students in their second semester are to enroll into the second component of the Longitudinal Seminar Series. This course is designed to support mentored QI work more centrally and allow for peer mentorship and individualized coaching. Working in small groups, students will meet periodically throughout the semester to develop their capstone projects with peer feedback. Specific frames for developing and documenting capstone work will be designed to support this course with specific milestones. The spring seminar will begin with an implementation plan. Students will reflect and be coached on the process of implementation with lessons in navigating change in a healthcare unit. This seminar will conclude with a capstone symposium where candidates will briefly present both their projects and their reflections as learners.
HQS 725:
Longitudinal Seminar Series I (part-time)
(Course Directors Brittany Esty, MD, Kae Santos, MBA, Marc Pimentel, MD, Joe Jacobson, MD, Jefferey Durney, MD, Claire Massero, MS)
Part time students in their first year are to enroll into the first component of the Longitudinal Seminar Series. This course is designed to support mentored QI work more centrally and allow for peer mentorship and individualized coaching. Working in small groups, students will meet periodically throughout the semester to develop their capstone projects with peer feedback. Specific frames for developing and documenting capstone work will be designed to support this course with specific milestones. The first seminar will focus on reviewing the framework for project work. Students will be expected to define the problem within the organization using QI tools such as mapping, fishbone diagrams, and key driver diagrams, as well as input from local stakeholders. Interventions will be proposed by end along with a projected implementation plan. Students will be asked to reflect on the process of moving from problem to design.
HQS 714: Practical Applications in Clinical Informatics
(Course Director: Bijay Acharya, MD)
Practical Topics in Health Informatics is an opportunity for clinical informatics pathway students to apply their informatics knowledge to the clinical operational sphere. Building on the foundations of HQS 707, this course will walk students through practical issues that arise when institutions want to rely on their information systems to study outcomes, facilitate improvement, or predict harm. In meeting with leaders in the field, students will have the opportunity to reflect on both the levers and challenges that arise and draft an approach to the task at hand. Sessions will be online and require prework; they will include lab time in addition to interactive teaching
sessions. Students will be asked to complete a proposal for how to address with a live issue or case study.
HQS 718: Capstone II
(Course Directors: Anjala Tess MD; Brittany Esty, MD, MPH Kae Santos, MBA)
Students in the MHQS program will complete an experiential capstone experience within the master’s program. This project will demonstrate the progressive achievement of the key competencies required for an MHQS student. Students will be asked to apply the tools, strategies, and methods from their didactic courses to develop a solution to an evidence-based problem seen in healthcare delivery. Each student will be paired with a mentor within a healthcare organization, and together they will select a specific problem driven by a need in quality, safety, informatics, or risk within the organization.
Successful completion of the capstone will be based on an assessment of a written paper that should be 15-18 pages long, including a comprehensive description of the process and steps performed as part of the experience. These modules provide students and mentors with essential information about how to prepare and submit the capstone experience manuscript in a format acceptable to Harvard Medical School.
VII. Expectations for students by term or year
Students are expected to participate fully in the required components of the program, including the longitudinal seminar, capstone, and courses.
Students will be formally evaluated in each course through participation, online quizzes, homework assignments, team projects, and written work. Attendance is required for all course meetings and students must pass all courses with an 80% to receive credit.
Students will complete a mentored quality and safety capstone, with some work contained in institutional centers for quality and safety, and some within clinical departments. Students will submit a written report that includes the required elements of the capstone project and submit it to program leadership.
Students are expected to maintain regular meetings with their assigned Program Director at least twice during each semester. Students will also meet with their project mentor as established at the start of the project, at least monthly, and more frequently as the project progresses.
Students are expected to abide by the policies outlined for HMS master’s students as outlined in the Master’s Student Handbook, including attendance and academic integrity, and in each school in which courses are taken.
VIII. Assessment
Students receive a final grade for each didactic course they take. This may be a letter grade if taken outside of HMS or a satisfactory/unsatisfactory rating if taken within the master’s program.
In addition, students are evaluated throughout each course through regular homework assignments, online quizzes, class participation, and/or team-based projects that are presented orally and/or in written form. A student must have the equivalent of a satisfactory grade for all courses to maintain satisfactory academic progress.
Students must be evaluated twice a year by their capstone coach and submit regular progress updates to the Program Director. This report will match elements of the capstone requirements. The Capstone advisory group will include the primary site mentor, the longitudinal seminar leader, and a MHQS program representative.
IX. Length of Time to Degree
Full-time MHQS students are expected to complete the degree program in one academic year (July-May). Part time students are expected to complete the program over the course of two academic years, or four semesters. Students may petition the Program Director in writing for an extension of time. In keeping with master's Governance policy, students should complete the program within 6 semesters.
Requirements for Graduation
Completion of the 36-credit curriculum, including a Capstone project with a written report is required. Students are expected to meet all academic, professional, and financial obligations required by HMS Master’s programs and outlined in the HMS Master’s student handbook. A degree will not be granted to a student who is not in good standing or against whom a disciplinary charge is pending. In addition, a student’s term bill must be paid in full before the student is awarded the degree.
X. Capstone Monitoring
The capstone project remains a key element of the MHQS program, even in a remote learning environment. In the online program, the capstone is supported by a tripartite collaboration between the student, their home institution mentor, and an HMS-based coach. The combination of the local mentor, the HMS coach, and program director formed the students’ capstone advisory group. This group is tasked with determining progressive achievement of the key competences required for an MHQS student. The capstone is entered and tracked via milestones in Canvas, which allows for bidirectional feedback and the opportunity to document changes. Students submit worksheets as well as 2 drafts and 1 final Capstone paper. Students receive feedback on all drafts and are expected to incorporate feedback into the final capstone paper. The paper is assessed by the capstone advisory group and an outside reviewer, each of whom assign scores and provide written feedback.
The student, and his/her local and HMS coaches met via videoconferencing if needed during the academic year in in alignment with the project milestones
Roles and responsibilities:
• Identify a mentor at local institution
• Complete project work at home institution
MHQS student
Home institution mentor
HMS coach
Program Director
• Submit all supporting capstone documentation
• Attend meetings with the local mentor and with HMS advisor as outlined
• Respond to feedback and complete revisions/remediation as requested
• Commit to responsibility for oversight via online attestation
• Attend introductory session to review responsibilities
• Meet with the student at least once a month or as dictated by project needs
• Review and sign the 7 capstone worksheets
•
• Communicate with student at least monthly – can be asynchronous
• Meet with student and local mentor if needed to guide the project
• Review milestone worksheets and drafts of the capstone
• Grade and provide feedback on written work and oral presentation
• Monitor students’ progress and flag any concerns to Program Directors
• Oversight of all capstones
• Monitor the progression of students through capstone milestones
• Meet as part of students’ capstone advisory groups to review capstone drafts and final paper
XI. Advising
Each student will benefit from ongoing advice from his or her primary mentor, in addition to the input from the Longitudinal Seminar coach. Students will also meet individually with their assigned Program Director twice per academic semester for formal career guidance and support. Program leadership will be available for any concerns throughout the year.
XII. Financial Aid
Program applicants are encouraged to apply for external grants and fellowships whenever possible.
MHQS has limited scholarship resources available through discretionary resources. Application for program scholarship support is made directly to the program director
Students who are enrolled at least half-time may be eligible for other federal or private aid.
XIII. Internship Information
Does not allow internships