Developing a Quality Improvement Curriculum in a Community-Based Orthopaedic Surgery Residency

In response to Accreditation Council of Graduate Medical Education (ACGME) directives, a resident-led quality improvement (QI) curriculum was implemented in our orthopaedic residency program. This study describes the evolution of this curriculum, the QI projects resulting from our program, and resident perceptions of the curriculum as an educational tool and a means to improve patient care and the residency experience.

QI teams consisted of one resident from each post-graduate year group filling the hierarchical roles of team leader, project coordinator, team recorder, and topic researcher. QI projects proposed by residents and approved by the program director were approached using Six Sigma methodology to Define, Measure, Analyze, Improve, and Control (DMAIC) the quality issue. In 6-8 conferences during the academic year, residents studied QI concepts and applied the principles learned to their selected topics. Current residents and recent graduates were surveyed regarding their experience with the curriculum.

Since 2016, residents conducted 22 QI projects of which 6 which were published in our university medical journal. Ten studies focused on improving patient care or community health, 10 augmented professional education, and 2 enhanced resident wellness. When surveyed, most current residents and recent graduates opined that our curriculum was an effective educational tool for the QI program. Among graduates, 89% of respondents indicated they have applied QI concepts learned during residency to improve patient care in their own practice.

Our curriculum, based on the DMAIC process, enabled residents to design and conduct effective QI projects thereby elevating the quality of our residency training program. The curriculum fulfilled the ACGME requirements and core competencies for orthopaedic residents in the QI domain and, more importantly, prepared graduates to champion QI initiatives for their own patients.