The World 2 Challenge is an innovative quality improvement competition designed by our Reynolds Next Steps team, based on the concept of a healthcare hackathon. We partnered with institutional leadership in our health system, graduate medical education leadership, nursing, physical therapy, pharmacy, and other interprofessional representatives to design a platform which promotes friendly competition led by specialty faculty, fellows, and residents aimed at improving quality of care for older adults. In the process, interprofessional teams learn key principles of geriatrics and how to apply them at a broader level across the institution. Our first competition in April 2016 focused on improving communication at transitions of care for older patients. At a retreat, 9 QI project "pitches" were delivered to a broad interprofessional audience, 5 were chosen by a voting process and developed their ideas further through interprofessional team collaboration. Ultimately, 2 project ideas were selected to go forward, and the ultimate winner of the QI competition was selected at the 2017 competition. The two finalists presented updates to judges who compared the projects and selected a winner with the most successful implementation and the broadest impact for the care of older patients institution-wide.
The second year of the World 2 Challenge was entitled Compassion & Dignity through Advance Care Planning and focused on increasing the prevalence of ACP documents among patients and staff of our health system. Twenty-nine proposals were received from resident-faculty dyads. Of these 10 were selected to pitch their project at the in-person retreat. Consulting teams of five to seven subject matter experts were assembled from the following domains: Family & Community Engagement Project Design & Implementation, Project Impact, Advance Care Planning. Two projects were selected as finalists and were provided funding and project management support to move forward to implementation. Teams presented findings and a winning team was selected after twelve months of implementation.
The project has several unique aspects that promote its success. The most important are the interprofessional focus, teamwork, contextual learning, and alignment with institutional priorities to make actual change in the way that patients are cared for at our institution. This has been an energizing effort, and similar programs have continued in our institution based on this model, including a modification to fit the Internal Medicine Residency Program’s curriculum in quality improvement. We provide a timeline that illustrates the key inputs and steps to promote such a QI competition to enhance geriatric education and care. We also provide the event agenda, pitch template, judging template, list of pitch topics, and follow-up in-house publicity from our institution to give our geriatrics colleagues at other institutions sample materials which could be adapted to their specific needs.