Plan-Do-Study-Act Cycles Applied to a Longitudinal Research Protocol in a Family Medicine Residency

Barriers to research in family medicine are common. Resident studies are at risk of remaining incomplete. This report describes a process improvement (PI) to optimize survey data collection in a longitudinal research protocol led by family medicine residents. The protocol subject to the process improvement sought to evaluate maternal outcomes in group prenatal care vs traditional care. In the months preceding the PI, the resident researchers noted many surveys were not completed in their intended timeframe or were missing, threatening study validity. We describe a practical case example of the use of a PI tool to resident-led research.

The residents applied three plan-do-study-act (PDSA) cycles over 8 months. Throughout the cycles, we solicited barriers and proposed solutions from the research team. Process measures included percentage of surveys completed within 2 weeks of the deadline ("on-time" response rate), and percentage of surveys completed overall.

A secure, shared survey tracker was created and optimized during three PDSA cycles to calculate and track survey deadlines automatically upon enrollment in the study. Automated colored flags appeared for due or overdue surveys. On-time response rates did not improve. Overall response rates did improve meaningfully from 57% (19 of 33 eligible) to 84% (16 of 19 eligible).

The PDSA cycles improved survey response rates in this research protocol. This intervention incurred no cost, was easily implemented, and was impactful. Other research teams can apply this PI tool to barriers in their research processes with minimal risk and cost.