Guthrie Clinic / Robert Packer Hospital, Sayre, PA
Promoting QI & Enhancing Patient Safety Through Graduate Medical Education: The Next Step?

Abstract

Background: Given the changing paradigm in healthcare and GME that emphasizes the importance of QI projects to enhance PS, we felt the need to incorporate this theory into resident education. We hoped to integrate PS/QI into the existing residency curriculum, increase the yield of QI projects, and have publications of resident-initiated QI projects.

Methods: We determined the success of our program by measuring the increase in resident QI activities as calculated on our new QI process scale. The scale has a score for each level of completion as follows: (1) conceptualization of project (no formal proposal), (2) formal hypothesis generated and submitted for review, (3) hypothesis approved by faculty mentor/QI supervisor after changes, (4) formal IRB proposal and IRB application completed, (5) IRB approval granted, (6) data collection underway, (7) preliminary manuscript developed and submitted for review, (8) manuscript finalized/submitted/under review, (9) manuscript accepted, and (10) project published/presented.

Results: We have seen a greater than 100% increase in resident-initiated QI projects since the beginning of this process. We worked to achieve resident buy-in and active contribution by discussing the significance of the program and its goals with residents. The most successful component of our work was generating interest from the faculty and increasing awareness of the significance of QI initiatives in practice and GME. We also established a streamlined procedure for seeking IRB review specifically for QI projects.

Conclusions: We were able to engage residents early by outlining resident-specific benefits of the process, maintaining an open dialogue between residents and faculty to identify specific needs and avoid attrition, and monitoring progress throughout the process to provide constructive feedback.