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Objective: To evaluate a multi-tiered approach to incorporating QI and PS training and participation in a pediatrics residency program. Methods: We developed a multi-tiered approach to QI/PS training during the 2013-14 year, and expanded upon it during subsequent years. We tracked resident participation in Departmental QI Grand Rounds and ACGME and Department survey results. The initial intervention involved didactic and small group sessions/to facilitate project development. We also instituted Departmental QI Grand Rounds. In the following year (2014-15), we increased the number of didactics and started a practice improvement project within the resident group practice where residents were provided individualized practice data. In 2016-17, we added an adapted Team-Based Learning session for PGY-1’s and all residents were required to complete on-line Institute for Healthcare Improvement modules. Results: In 2013/14, 26 residents presented 2 oral and 12 poster presentations at QI Grand Rounds. This increased to 36, 2 & 14 in 2014/15, 43, 3 & 17 in 2015/16, and 26, 2 & 13 in 2016/17. In 2012/13, 50% of residents responded affirmatively to the ACGME survey question 'participated in QI'; (19% affirmed they were 'provided data about practice habits'). This increased to 86(29) in 2013/14; 81(48) in 2014/15, 83(42) in 2015/16, and 78(48) in 2016/17. Conclusions: We have implemented a multi-pronged QI curriculum that includes all resident levels. Results demonstrate increased resident involvement. Key to buy-in is the ability to participate in high-interest projects within self-designated tracts. Future directions include further study of the curriculum and of the system/patient safety outcomes.
Bagian, J. P., & Weiss, K. B. (2016). The Overarching Themes from the CLER National Report of Findings 2016. J Grad Med Educ, 8(2 Suppl 1), 21-23. doi:10.4300/1949-8349.8.2s1.21 Lane-Fall, M., Davis, J. J., Clapp, J., Myers, J. S., & Riesenberg, L. A. (2017). What Every Graduating Resident Needs to Know About Quality Improvement and Patient Safety: A Content Analysis of 26 Sets of ACGME Milestones. Acad Med. doi:10.1097/acm.0000000000002039 Liao, J. M., Co, J. P., & Kachalia, A. (2015). Providing Educational Content and Context for Training the Next Generation of Physicians in Quality Improvement. Acad Med, 90(9), 1241-1245. doi:10.1097/acm.0000000000000799 Patow, C. A., Karpovich, K., Riesenberg, L. A., Jaeger, J., Rosenfeld, J. C., Wittenbreer, M., & Padmore, J. S. (2009). Residents' engagement in quality improvement: a systematic review of the literature. Acad Med, 84(12), 1757-1764. doi:10.1097/ACM.0b013e3181bf53ab Windish, D. M., Reed, D. A., Boonyasai, R. T., Chakraborti, C., & Bass, E. B. (2009). Methodological rigor of quality improvement curricula for physician trainees: a systematic review and recommendations for change. Acad Med, 84(12), 1677-1692. doi:10.1097/ACM.0b013e3181bfa080
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