Table 1 Case scenarios as related to core and cross-cutting domains

Scenario Summary

Implementing a depression screening care standardization tool as part of the Centers of Medicare and Medicaid Services (CMS) Merit-based Incentive Payment System (MIPS) at an outpatient clinic

Negotiation scenario to develop a new resident rotation and necessary hires to run a step-down unit, within the confines of a tight budget, staffing, and short timeline for implementation

Root cause analysis (RCA) of a serious safety event (SSE) concerning a high-risk fall patient who sustains a fall with injury when a nurse left to assist another patient

Participant Roles

Medical Director, Front Desk Staff Member, Clinic Provider, Informaticist, Patient/Family Representative, and Clinic/Nurse Manager

Vice Chair of Clinical Affairs, Program Director, Vice President of Clinical Operations, Chief Resident, and Medical Director of Hospitalist Service

Vice President of Patient Services, Clinical Program Manager, Subject Matter Expert, RCA analyst, Medical Director, and Quality and Safety Director

Main Teaching Points

Barriers to Implementation; Social determinants of health; Exploration, Preparation, Implementation, Sustainment (EPIS) framework [10]

Educational impact; Faculty development and resident supervision; “Best Alternative to a Negotiated Agreement” (BATNA) [11]

Systems-level factors; Quality improvement opportunities

Core Domains in Health Systems Science

Health care policy, financing, and management; Value-based care; Clinical Informatics

Healthcare structures and processes; Population and public health

Healthcare structures and processes; Health system improvement

Cross-cutting Domains

Evidence-based practice and Teamwork

Leadership and Change Management

Professionalism and Ethics