A Recipe for a Continuous Quality Improvement Program in Surgical Residency.

Area of Science:

• Medical Education
• Surgical Training
• Quality Improvement Science

Background:

• General surgery residency programs require robust training in quality improvement (QI).
• Effective QI education is essential for enhancing patient safety and healthcare outcomes.
• Existing curricula may lack comprehensive didactic and practical components.

Purpose of the Study:

• To design and implement a multifaceted QI educational curriculum for general surgery residents.
• To analyze the effectiveness of the QI curriculum in improving resident knowledge, skills, and interest.
• To identify key factors for successful QI curriculum implementation in residency programs.

Main Methods:

• Prospective study utilizing Plan-Do-Study-Act (PDSA) methodology over four academic years (2020-2024).
• Implementation of a three-pronged curriculum: didactic lectures, resident-led QI projects, and QI-focused morbidity and mortality conferences.
• Longitudinal cohort assessment with surveys at the end of each PDSA cycle to evaluate educational impact and resident engagement.

Main Results:

• Improvements observed in resident education on QI topics, participation in QI activities, and knowledge of QI principles.
• Resident-led, faculty-mentored QI projects were successfully implemented, leading to real-time QI work completion.
• Plan-Do-Study-Act (PDSA) methodology facilitated adaptation to barriers, such as transitioning to virtual lectures and creating protected time for QI projects.

Conclusions:

• A multifaceted QI curriculum integrating didactic and practical elements is feasible and effective for general surgery residency programs.
• The curriculum significantly increased residents' knowledge, comfort, and interest in quality improvement.
• Faculty support, resident engagement, program management, and leadership are critical for successful QI curriculum implementation.