Orlando Health, Orlando, FL
Quality Improvement – A Humbling Experience Triggering Change in Resident Education Revisited

Abstract

Background: Quality improvement has become an essential part of all aspects of clinical medicine. After the Institute of Medicine's landmark To Err Is Human report in 1999, many institutions, including Orlando Health, incorporated quality improvement into their GME curriculum. We implemented the IHI Open School training modules as a core training curriculum for residents. After more than 1 year of training, a reassessment of residents' quality improvement knowledge was deemed prudent.

Methods: We conducted a literature survey to identify available questionnaires and created a baseline questionnaire. The questionnaire was administered to residents of internal medicine, and IHI quality improvement training was provided. A maintenance questionnaire was administered, and the posttest assessment was compared with maintenance results.

Results: The posttest passing rates by department after completion of the IHI quality improvement training were 64.3% for internal medicine, 52.6% for emergency medicine, 78.9% for pediatrics, 100% for Ob/Gyn, 64.7% for surgery, 100% for pathology, and 88.9% for orthopedics. The maintenance test passing rates by department were 30% for internal medicine, 33% for emergency medicine, 10% for pediatrics, 17% for Ob/Gyn, 50% for surgery, 25% for pathology, and 36% for orthopedics.

Conclusion: The maintenance questionnaire results forced us to reevaluate the effectiveness of our core curriculum and whether the lack of retention requires ongoing quality improvement training.