PC1248: Development of a Quality Improvement Curriculum Within a Pediatric Residency Program

Background: Quality improvement continues to be increasingly important throughout all levels of healthcare. Resident participation is required by the ACGME under the competency of “practice-based learning and improvement.” The American Board of Pediatrics also now requires Quality Improvement (QI) projects for recertification. To address this focus, a QI curriculum was developed within our pediatric residency program. The programs' goals were to develop a strong foundation of quality improvement, improve the quality of education surrounding QI, as well as increase participation in research from the residents and faculty. Below we describe the implementation of our curriculum and how we addressed previous barriers to accomplish significant improvement within the residency program.

Methods: Our first objective was to develop the team to support the curriculum. Partnerships established included librarians, statisticians, IRB support, professional development, and grant writing representatives. To address the barrier of dedicated time for projects encountered with prior implementation, we allowed for dedicated worktime within our lecture and workshop series. The didactic portion of this focused on the basics of QI, literature reviews, grant writing, data analysis, and poster construction. Within a rolling curriculum, we introduced the first-year residents to EQUIPP for residents through the AAP to give them a base understanding of QI and complete an introductory QI project. At the start of their second year the residents completed SMART AIM statements and worked with the support team to develop and implement their projects. The residents also identified a faculty “champion” to serve as their mentor. As a third-year resident the projects were finalized and then presented at grand rounds in the winter of their third year. Feedback from the residents was collected at the completion of each year.

Results: Eleven residents have graduated the program since the curriculum was initiated. All residents have completed projects during that time, despite many projects being put on hold due to the COVID-19 pandemic. Results of the resident survey showed improved understanding of QI work as well as increased project completion rates. The format of the curriculum was also adjusted to monthly lectures and workshops to allow more frequent engagement and education opportunities. Increases in faculty QI work, as well as local presentations were seen over the first two years. Smaller but still significant improvement was seen in regional presentations and EQUIPP module completion rates.

Conclusion: Instituting a formal quality improvement curriculum within a pediatric residency program improved the baseline knowledge of quality improvement as well as increased the participation in quality improvement and research throughout the program. Providing dedicated didactic time to educate and allow the residents to work on their projects increased resident buy-in as well as completion rates. This work impacted not only the residents but also the faculty and the community at large.