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Integrating improvement competencies into residency education: a pilot project from a pediatric continuity clinic
Julie J Mohr1, Greg D Randolph, Matthew M Laughon
1Department of Anesthesia and Critical Care, University of Chicago, Chicago, IL 60637, USA. jmohr@dacc.uchicago.edu
Objective:
The Accreditation Council for Graduate Medical Education (ACGME) requires residents to attain 6 core competencies. This article describes a model for integrating 2 of these competencies (practice-based learning and improvement and systems-based practice) into residency education and assesses the clinical outcomes achieved for patients.
Study Design:
An observational study with before-after comparisons.
Intervention:
Pediatric faculty facilitated multidisciplinary improvement team meetings (which included 8 residents) and implemented an established improvement model to improve the selected clinical condition (immunizations).
Main Outcome Measures:
The proportion of consecutive children who were up-to-date on DTP, polio, MMR, HIB, and hepatitis B vaccines by 24 months of age.
Results:
The residents' improvement team successfully implemented 5 changes in the clinic process, which coincided with an increase in immunization rates for 2-year-olds during the 1-year study period. Clinic immunization rates increased from 60% at baseline to 86% at follow-up (P =.04).
Conclusion:
This study suggests that it is feasible to integrate practice-based learning and improvement and systems-based practice into residency education while providing a valuable learning experience for residents and improving patient outcomes.