Residents as Leaders: Using a Delphi Process to Conduct an Institutional Preoperative Patient Optimization Quality...

Area of Science:

• Medical Education
• Quality Improvement
• Patient Safety

Background:

• Residency programs face challenges meeting Accreditation Council for Graduate Medical Education (ACGME) requirements for resident involvement in quality improvement (QI).
• Engaging trainees in QI initiatives is crucial for developing future healthcare professionals skilled in improving patient care.

Purpose of the Study:

• To develop a framework for involving surgical and anesthesiology trainees in an institutional QI effort focused on preoperative patient optimization.
• To assess the perceived value of trainee participation in a QI initiative using a modified Delphi consensus methodology.

Main Methods:

• Trainees and content experts collaborated on systematic reviews of 7 key preoperative risk factors.
• Institutional recommendations were developed using modified Delphi consensus methodology.
• An electronic survey evaluated trainee perceptions of the QI process and their learning outcomes.

Main Results:

• Fifty-one stakeholders, including 26 trainees, participated; residents led most working groups.
• Trainees reported significant increases in understanding of their subject areas (88.2%) and the Delphi method (82.4%).
• A large majority of trainees (82.4%) expressed willingness to participate in similar QI initiatives.

Conclusions:

• A novel framework effectively integrates trainees into institutional QI efforts, enhancing education in QI, systematic reviews, Delphi methodology, and preoperative optimization.
• This model offers a replicable strategy for residency programs to fulfill QI requirements and foster resident engagement.