A Practical Approach to Quality Improvement Education for New Educators.

Abstract: The Accreditation Council for Graduate Medical Education's mandate for quality improvement (QI) training in residency programs has generated discussion in the literature of QI best practices and curriculum models. Despite this requirement, residents continue to report limited exposure to domains like available QI expertise, access to data collection, QI knowledge, and ability to complete all project stages.While the barriers to successful QI project implementation are numerous, the lack of experienced QI educators is also a major limitation. Educators new to QI education may not know how to approach common project pitfalls residents face, namely their tendency to jump to the "do" phase in a Plan-Do-Study-Act (PDSA) cycle without prior framing of the problem through process evaluation and identification of timely measures. These pitfalls can lead to many unintended consequences, including diminished physician engagement in QI work.To focus residents on learning about health systems, the authors draw on their collective experiences as learners and educators to propose a practical approach for new QI educators, consisting of 4 objectives: (1) illustrate and evaluate the process; (2) obtain meaningful and timely measures; (3) propose an intervention and obtain feedback from high-level stakeholders; and (4) reflect on lessons learned throughout the endeavor. The authors assert that by prioritizing these objectives before embarking on a PDSA cycle, residents will learn more about systems of care, gain competency in analyzing these systems, and continue QI efforts successfully in their future careers.