42 - Creating a Quality Improvement, Patient Safety, and Healthcare Value (QIPSHV) Curriculum for Pediatric Residents

Poster Number: 42
Publication Number: 42.2927

Background: The ACGME requires residents to receive training in quality improvement (QI), patient safety (PS), and healthcare value (HV) to improve their ability to provide quality care to patients. Our program lacked a formalized curriculum covering these topics. Furthermore, there is a dearth of literature surrounding the creation of a unifying curriculum covering these areas.

Objective: To create a novel, unifying curriculum encompassing QIPSHV concepts that meets the needs of pediatric residents.

Design/Methods: A QIPSHV curriculum was created using Kern’s 6-step approach to curriculum development. A curriculum oversight committee was established and consisted of a faculty sponsor, chief resident, and pediatric residents. The curriculum included resident-led conferences, didactics, a scholarly project forum, and wards QI mini-projects (Figure 1). Residents completed pre- and post-implementation surveys to assess curriculum efficacy. Surveys included knowledge-based and Likert scale questions.

Results: Out of 80 residents, 42 completed the pre-survey and 12 completed the post-survey. Prior to implementation, 57% of residents denied formal training on QIPSHV concepts. Following implementation, conference attendance to QI, PS, and HV topics increased by 108%, 110%, and 75%, respectively. Ability to correctly identify a PDSA cycle increased from 83% to 100%. Knowledge of the healthcare value equation increased from 88% to 92%. Comfort with incorporating QI principles based on a mean likert score increased from 3.2 to 3.7. Comfort with submitting a PS report increased from 3.5 to 4.3. Comfort with incorporating costs of tests in practice increased from 2.7 to 3.4 (Table 1, Figure 2).

Conclusion(s): We successfully developed and implemented a QIPSHV curriculum as evidenced by increased knowledge, self-confidence, and engagement of residents. While separate QI, PS, and HV curriculums have been previously studied, this curriculum is unique in that it combines all three topics. Additionally, the creation of a curriculum oversight committee is a novel approach that ensures sustainability. A limitation of this study is the lack of survey responses. This project was recently awarded a grant, which will be used to incentivize future survey completion. Additional future directions of this project include development of a quarterly journal club, a QIPSHV elective, and a longitudinal track for those interested in a QIPSHV focused career. Next steps for our research include examining rates of resident reported safety events pre- and post- implementation, as well as examining changes in ACGME survey responses.