Developing And Implementing A Quality Improvement Curriculum In A Large Internal Medicine Residency Program

Abstract

Abstract Background: The delivery of chronic care is increasingly complex, and the need for physicians who are competent in system-based practice and quality improvement (QI) is evident. Organizations like the American Board of Internal Medicine and the Accreditation Council for Graduate Medical Education have included QI knowledge in their recertification and accreditation requirements Objective: The goal of this curriculum is to give internal medicine residents a working knowledge of the Model for Improvement by carrying out a QI project over an academic year. Methods: A longitudinal QI curriculum was developed, providing residents with QI skills. Each resident participated in interactive seminars as well as a faculty-mentored, team-based QI project. Success of the curriculum was measured by the formal evaluation of each improvement team’s end-of-the-year poster presentation. Results: Between 2007 and 2016, the curriculum covered over 120 year-long team projects. A pre-survey included 51 PGY-1 residents (59% respondent rate) and a post-survey includes 50 PGY-2 and PGY-3 residents (46% respondent rate) used as part of evaluation demonstrated increased comfortability leading a QI project and overall knowledge of QI principles. We continue a modified version of the curriculum after 2016 as the residency program changed to a x+y model and impacts of the COVID-19 pandemic. Conclusion: Implementing a performance improvement curriculum based in a resident continuity clinic is feasible and affords several advantages. In applying QI methodologies, residents learn how to measure adherence with current evidence-based medicine guidelines and develop interventions to maintain positive momentum within the reality of busy clinical practice.