Strategies for Institutional Adoption

These tips and tools are designed to assist in communicating the importance of CRIT in order to get Institutional buy-in.

Tips on Promoting CRIT

  • Devote considerable time and effort to CRIT marketing and recruitment in the first year This initial investment will mean you’ll have a much easier time promoting CRIT in subsequent years, as the program is known and has a track record of success throughout the institution.
  • Create a strong liaison with the publicity department and chief of communications. Highlight the novel innovative aspects of CRIT for patient care and education. Suggest angles for articles in local media such as the CRIT’s value in helping older orthopedic patients return to the tennis court. If necessary, the CRIT faculty can provide its own draft of an article to help the publicity department get started. Suggest that the institution produce a video on the CRIT program. Contact public radio.  Boston Medical Center’s model CRIT was highlighted on a syndicated public radio show,” Here and Now”.  Invite members of the communications department to CRIT for personal experience.
  • Use communication pieces to spread the message about the value of CRIT and to demonstrate its impact.  Publish information about CRIT in institutional newsletters and internal online communiques. (see Tools)
  • Present the results of the national CRIT outcomes surveys and your institutional outcomes. These will help to demonstrate the value of CRIT to the institution.  (see Tools)
  • Emphasize the CRIT objective of providing leadership skills training to incoming chief residents.  This is a universal need among all institutions and well be easily understood and valued.
  • Present information on your CRIT program at Grand Rounds
  • Highlight unintended spin-offs that can occur as a result of CRIT, such as:
    • Interactions between geriatrics and other specialties that occur throughout the academic year focused on problem-solving around geriatrics cases.
    • chief resident poster submissions to the American Geriatrics Society annual meeting.
  • Reach out to other local medical centers and invite them to join your CRIT program. You can also help them to create their own so that the CRIT penetrates a larger area, benefits more practitioners and patients, and has access to more funding sources. 

Tips on Engaging Institutional Leaders

  • To create buy-in for CRIT, consider co-leading the program with an Internal Medicine faculty member As a team, meet with individual residency program directors to describe the program.  These face-to-face meetings go a long way in recruiting chief resident and faculty participation, and generate better results than just e-mailing invitations.
  • Involve the following individuals as valuable partners in CRIT promotion, fundraising, and sustainability Invite these individuals to attend CRIT.  Some of these individuals are also appropriate to invite to serve as CRIT co-PIs or faculty:
    • Designated Institutional Official
    • Graduate Medical Education leadership
    • Residency Program Directors (consider having a program director from a non-primary care specialty serve as the CRIT co-PI)
    • Hospital leadership (CEO, CMO, VP for Clinical Affairs, VP for Quality and Safety)
    • Deans/Department Heads/Division Chiefs
    • Medical Directors of Quality and Safety
    • Nursing Administrators
    • Development and Communications Officers
  • Present the CRIT model and program at an institutional GME staff meeting, with the GME Dean, DIO and GME Chair or Dean presiding.  This can support CRIT promotion and recruitment, and help CRIT to become more ingrained in the culture and pattern of training. Getting the Dean’s support at the beginning also encourages the involvement of other departments.
  • Invite hospital leadership to a CRIT program and dinnerThis enables them to see first-hand the important interspecialty communication and collegiality that CRIT engenders, and makes them feel more engaged in the program.
  • Invite nursing administrators to participate in or lead the CRIT case discussions.  Include pharmacy and social work as well.

Tips on Demonstrating How CRIT Benefits the Institution

  • Develop an online tutorial based on your CRIT program.  This case-based curriculum can serve as a tool for chief residents to brush up on material covered at the CRIT training program.  Make this available institution-wide as a promotional tool for CRIT.
  • Consider developing a combined geriatrics intensive training program for chief resident, fellow, and faculty development This will help to maximize resources and can facilitate both institutional buy-in and fundraising.
  • Link your CRIT program goals with institutional goals.  For example, you may obtain increased buy-in from hospital administrators and departments by emphasizing how the CRIT program:
    • Enhances teaching and leadership skills
    • Enhances interspeciality and interdisciplinary team training and collaboration
    • Increases geriatrics knowledge of physicians at various levels of training and professional development, from medical students to senior faculty
    • Has the potential to improve care quality and safety through interspecialty collaboration and increased knowledge of geriatrics care.
  • Be aware that some hospital leaders see chief residents as transient.  In addition to chief residents, be prepared to discuss how CRIT benefits many others within the institution, including patients and their families, medical trainees, faculty, other hospital staff, and the institution. Institutions are proud of their CRs who go on to become leaders in other institutions after fellowship.
  • Work with hospital leaders to link CRIT to efforts to reduce preventable readmissions.  The skills and approaches needed to prevent readmissions could be incorporated into the CRIT curriculum by focusing a learning module on discharge planning. Present CRIT to the GME committee, residency program directors, and others both pre- and post-CRIT.  Providing follow-up information on the CRIT program and outcomes helps to solidify the program within the institution and supports ongoing institutional engagement and support. Put together a slide show.

Tools

2010 CRIT overview (PDF | DOC )

Summary of CRIT aggregated data