Adapting the Toyota production model to teach systems-based practice to anesthesiology fellows

What does the Accreditation Council for Graduate Medical Education (ACGME) core competency in systems-based practice (SBP) mean for anesthesiologists? The broad ACGME definition of SBP is "an awareness of and responsiveness to the larger context and system of health care and the ability to effectively call on system resources to provide care that is of optimal value." They further refined the definition into 6 resident expectations known as milestones [1], and subsequent education expert consensus has provided additional operational definitions [2,3].

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