Practical, Iterative Cycle Quality Improvement Teaching in Continuity Clinic: An Opportunity for Resident Innovation and Engagement

Course Overview

The ACGME requires that all residents receive training in quality improvement (QI), which includes teaching general QI concepts as well as promoting reflection on their own practice patterns. Resident continuity clinics serve as an ideal location to teach QI. Trainees can utilize PDSA cycles to impact their own patients' care. Our residency program has developed a successful QI curriculum that utilizes 3-6-month project cycles following the PDSA format. At the beginning of each academic year, our residents are taught general QI principals. As a group, residents then develop focused QI projects to implement in their continuity clinic sequentially over the course of the academic year. The resident-driven nature of the process fosters innovation and investment. Every project has a resident lead, faculty oversight and one or more key clinic staff partners. Residents utilize ambulatory blocks, electives and dedicated time during our monthly Med-Peds Academic Half-Day to work on the project. We highlight one project where the residents designed an intervention to incorporate racial justice discussions into well visits. We have shown that in a 6-month timeframe the residents are able to 1) design an innovative, patient-facing intervention; 2) implement the project, measure outcomes, and conduct multiple iterative revisions based on feedback and measures; 3) share their findings at national conferences and spread the intervention to other local pediatric clinics, and 4) gain confidence in implementing their own QI projects in the future. Attendees will leave the seminar with practical steps to implement a similar QI curriculum at their own institution.

Learning Objectives

Attendees will gain skills in creating a Quality Improvement Curriculum that actively engages residents.
Attendees will learn how to implement multiple resident-initiated improvement projects into continuity clinics during an academic year.
Attendees will explore how to incorporate anti-racism work into Quality Improvement efforts.

Speakers

Niraj Sharma, MD, MPH
Harvard Medical School Brigham and Women's Hospital