414 - Impact of a Pediatric Resident-led Integrated Quality Improvement Curriculum

Poster Number: 414
Publication Number: 414.445

Reymundo C. Bisarini, Einstein Medical Center - Philadelphia, Philadephia, PA, United States; Ali Abdelhafiz, Einstein Medical Center - Philadelphia, philadelphia, PA, United States; Afaf s. Ahmed, albert Einstein medical center, philadelphia, PA, United States; Mayssa Abuali, Einstein Medical Center Philadelphia, Philadelphia, PA, United States

Background: A resident needs assessment identified Quality Improvement (QI) skills gaps. Studies have shown successful QI curriculums enable residents to improve patient care processes, however little is known about resident-led QI curriculums.

Aim: Within 12 months, develop an effective resident-led QI curriculum for the Pediatrics program with the end goal of integrating QI into improving patient care.

Objective: At the end of the curriculum, participating residents will be able to:
1. Define the Model for Improvement.
2. Identify patient care processes in need of improvement.
3. Formulate a SMART(IE) AIM and develop measures (outcome, process, balancing).
4. Design QI projects and implement PDSA cycles addressing patient safety and healthcare disparities.

Design/Methods: Methods: Launch date 7/1/2021 with target of 30 residents.
Planning:
• Prelaunch, trained three resident QI champions through small group faculty led sessions, online Institute for Healthcare Improvement (IHI) modules, and Academic Pediatric Association QI conference attendance.
• Obtained an educational innovation grant.
Teaching:
• Small group resident sessions facilitated by QI expert faculty.
• Flipped classroom utilizing IHI modules-QI champion resident-led discussions with faculty coaching.
• Workshops on Aim and Measures led by resident QI champions.
Learner

Assessment:
• Pre/Post curriculum resident self-assessments of comfort level/self-efficacy and perceptions of value (1-5).
• QIKAT-R validated tool (3 points each for AIM, Measure, Change) to evaluate resident skills on three simulated clinical scenarios.
Program Evaluation:
• Change in clinical processes based on successful resident-led PDSA cycles.

Results: In the initial five months, 20 residents participated. On post curriculum self-assessments, comfort constructing an AIM statement increased from 18% to 65% at highest levels (4-5) of proficiency. Ability to develop measures increased from 18 to 30 % (figure 1). Resident participation in PDSA cycle remained stable at 30 %. Residents continued to strongly agree on the high value of QI. QIKAT scoring showed variable proficiency (figure 2,3). A resident-led project improved timely follow up of urgent ambulatory lab results from 60 % to 78% in 3 months (ongoing).Conclusion(s): A resident-led QI curriculum utilizing peer education shows promise in enhancing fundamental QI skills and improving patient care. Next steps include integrating QI into daily workflow and developing longitudinal projects linked to patient outcomes.
Ali Abdelhafiz CVAli Abdelhafiz_Resume.pdf
Figure 2: QIKAT score per training year (n=15)