X + Y = Time for QI: Meaningful Engagement of Residents in Quality Improvement During the Ambulatory Block.

Authors

• Krista M Johnson
• Wendy Fiordellisi
• Ethan Kuperman
• Alexis Wickersham
• Carly Kuehn
• Aparna Kamath
• Joseph Szot
• Manish Suneja

Publication/Presentation Date

6-1-2018

Abstract

BACKGROUND: Meaningful resident engagement in quality improvement (QI) remains challenging. Barriers include a lack of time and of faculty with QI expertise. We leveraged our internal medicine (IM) residency program's adoption of an "X" (inpatient rotations) plus "Y" (ambulatory block) schedule to implement a QI curriculum for all residents during their ambulatory block.

OBJECTIVE: We sought to engage residents in interprofessional QI, improve residents' QI confidence and knowledge and application to practice, and create opportunities for QI scholarship.

METHODS: In July 2015, the program provided dedicated time for QI in the ambulatory block. All categorical IM residents and 11 voluntary faculty mentors were divided into 10 teams based on clinic site and "Y" block schedule. Teams participated in resident-led, interprofessional ambulatory QI projects. Resident QI knowledge and confidence were assessed before the curriculum and 11 months after using the Quality Improvement Knowledge Application Tool-Revised (QIKAT-R) and surveys. QI project implementation and scholarship were tracked.

RESULTS: All categorical residents (N = 81) participated. Residents reported increased confidence in all QI skills, and they demonstrated increased knowledge, with mean QIKAT-R paired scores improving from 15.8 ± 4.6 to 19.1 ± 5.9 (n = 45 pairs,

CONCLUSIONS: This ongoing curriculum engaged IM and IM-psychiatry residents in QI during their ambulatory block using volunteer clinic faculty mentors. Residents demonstrated improved QI confidence and knowledge. The majority of resident projects were sustained and generated scholarship.

Volume

10

Issue

3

First Page

316

Last Page

324

ISSN

1949-8357

Published In/Presented At

Johnson, K. M., Fiordellisi, W., Kuperman, E., Wickersham, A., Kuehn, C., Kamath, A., Szot, J., & Suneja, M. (2018). X + Y = Time for QI: Meaningful Engagement of Residents in Quality Improvement During the Ambulatory Block. Journal of graduate medical education, 10(3), 316–324. https://doi.org/10.4300/JGME-D-17-00761.1

Disciplines

Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods

PubMedID

29946390

Department(s)

Administration and Leadership

Document Type

Article