Core Competencies

3.18 Practice-Based Learning and Improvement

© 2017 Society of Hospital Medicine

Practice-based learning and improvement (PBLI) is a means of evaluating individual and system practice patterns and incorporating the best available evidence to improve patient care. PBLI is recognized as a critical skill for all clinicians by the Accreditation Council for Graduate Medical Education (ACGME), the American Board of Internal Medicine (ABIM), the American Board of Pediatrics (ABP), and the American Academy of Family Physicians (AAFP). As the practice of hospital medicine rapidly evolves, hospitalists apply the most up-to-date knowledge to their care of inpatients. Hospitalists use a PBLI approach to lead, coordinate, and participate in initiatives to improve hospital processes and clinical care.

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Hospitalists should be able to:

  • Describe systematic methods of analyzing practice experience.

  • Explain key concepts of practice-based improvement methodology, which include the plan-do-study-act (PDSA) model.

  • Define the role of multidisciplinary teams and team leaders in improving patient care.

  • Describe how the critical appraisal and assimilation of scientific evidence applies to PBLI.

  • Describe how information technology can be used to identify opportunities to improve patient care.


Hospitalists should be able to:

  • Translate information about a general population into management of subpopulations or individual patients.

  • Critically assess individual and system practice patterns and experience to identify areas for improvement and minimize heterogeneity of practice.

  • Design practice interventions to improve quality, efficiency, and consistency of patient care using standard PBLI methodology and tools.

  • Critically assess medical information to support self-directed learning.

  • Critically appraise and apply the reports of new medical evidence.

  • Identify and use high-quality, evidence-based information resources to inform clinical decisions.

  • Use health information systems efficiently to manage and improve care at the individual and system levels.


Hospitalists should be able to:

  • Advocate for the use of PBLI in clinical practice and in system improvement projects.

  • Create an environment conducive to self-evaluation and improvement and seek to incorporate formative feedback into daily practice.

  • Advocate for investment in information technology that can harness up-to-date clinical resources.

  • Facilitate and encourage self-directed learning among healthcare professionals and trainees.

  • Promote self-improvement and care standardization using best evidence and practice.

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