Objective:

To establish a resident-led system-based quality improvement (QI) committee and curriculum within a Neurology Residency Program that fosters a collaborative, positive approach to the development and implementation of engaging, real-time application QI projects. 

Background:

The Accreditation Council for Graduate Medical Education (ACGME) requires QI education for all residency programs; however, there is a lack of interest among trainees. Hospital systems utilize faculty and staff on QI projects, but trainees do not often play a major role. 

Design/Methods:

Department of Neurology residents and fellows were invited to participate in the QI committee (n=37). The QI Curriculum was developed with a focus on QI principles and study design, with the goal of designing initiatives to improve patient care, workflow, and residency culture in the department. Committee members proposed projects and then voted on which QI projects to enact. Quarterly didactic sessions occurred while projects were ongoing. Surveys were sent at the initiation of the committee to establish a baseline familiarity with QI amongst trainees, half-way through the year, and at the end of the academic year. 

Results:

25 of 37 Neurology trainees completed Survey 1. Survey 1 demonstrated limited QI exposure regardless of post-graduate year. Surveys 2 and 3 demonstrated a significant association (p=0.02) between committee membership and level of interest in QI. Survey 3 demonstrated significant associations between committee membership and 1) level of comfort/experience in QI (p=0.03), 2) perceived extent to which QI will affect trainees' future career (p=0.047), and 3) level of comfort proposing a QI project (p=0.01). 

Conclusions:

Those who participated in the QI committee showed greater interest in QI over time, improved experience in QI research, and greater comfort in proposing new initiatives compared to non-committee trainees. This study’s findings may serve as the basis for the creation of resident run quality improvement education and initiatives at other training programs.