Overcoming challenges to removing inappropriate penicillin allergy labels: A quality improvement report

Abstract Over 3 months, we provided monthly education to internal medicine residents and distributed resources regarding penicillin-allergy history taking. Allergy information in the electronic record was updated more often during the intervention compared to the period before the intervention (16.1% vs 10.9%; P = .02). Education and interdepartmental collaboration have the potential to affect provider behavior.

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Clinical and Educational Outcomes of an Integrated Inpatient Quality Improvement Curriculum for Internal Medicine Residents

Journal of Graduate Medical Education ◽

10.4300/jgme-d-15-00412.1 ◽

2016 ◽

Vol 8 (4) ◽

pp. 563-568 ◽

Cited By ~ 19

Author(s):

Greg Ogrinc ◽

Emily S. Cohen ◽

Robertus van Aalst ◽

Beth Harwood ◽

Ellyn Ercolano ◽

...

Keyword(s):

Internal Medicine ◽

Quality Improvement ◽

Self Efficacy ◽

Intervention Group ◽

Educational Outcome ◽

Free Text ◽

Internal Medicine Residents ◽

Late Intervention ◽

Hands On ◽

The Impact

ABSTRACT Background Integrating teaching and hands-on experience in quality improvement (QI) may increase the learning and the impact of resident QI work. Objective We sought to determine the clinical and educational impact of an integrated QI curriculum. Methods This clustered, randomized trial with early and late intervention groups used mixed methods evaluation. For almost 2 years, internal medicine residents from Dartmouth-Hitchcock Medical Center on the inpatient teams at the White River Junction VA participated in the QI curriculum. QI project effectiveness was assessed using statistical process control. Learning outcomes were assessed with the Quality Improvement Knowledge Application Tool–Revised (QIKAT-R) and through self-efficacy, interprofessional care attitudes, and satisfaction of learners. Free text responses by residents and a focus group of nurses who worked with the residents provided information about the acceptability of the intervention. Results The QI projects improved many clinical processes and outcomes, but not all led to improvements. Educational outcome response rates were 65% (68 of 105) at baseline, 50% (18 of 36) for the early intervention group at midpoint, 67% (24 of 36) for the control group at midpoint, and 53% (42 of 80) for the late intervention group. Composite QIKAT-R scores (range, 0–27) increased from 13.3 at baseline to 15.3 at end point (P < .01), as did the self-efficacy composite score (P < .05). Satisfaction with the curriculum was rated highly by all participants. Conclusions Learning and participating in hands-on QI can be integrated into the usual inpatient work of resident physicians.

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Teaching Internal Medicine Residents Quality Improvement and Patient Safety: A Lean Thinking Approach

American Journal of Medical Quality ◽

10.1177/1062860609357466 ◽

2010 ◽

Vol 25 (3) ◽

pp. 211-217 ◽

Cited By ~ 47

Author(s):

Christopher S. Kim ◽

Michael P. Lukela ◽

Vikas I. Parekh ◽

Rajesh S. Mangrulkar ◽

John Del Valle ◽

...

Keyword(s):

Internal Medicine ◽

Patient Safety ◽

Quality Improvement ◽

Lean Thinking ◽

Internal Medicine Residents

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Swimming With Sharks: Teaching Residents Value-Based Medicine and Quality Improvement Through Resident-Pitched Projects

Journal of Graduate Medical Education ◽

10.4300/jgme-d-19-00421.1 ◽

2020 ◽

Vol 12 (3) ◽

pp. 320-326 ◽

Cited By ~ 1

Author(s):

Matthew S. Durstenfeld ◽

Scott Statman ◽

Kerrilynn Carney ◽

Brigette Cohan ◽

Brian Bosworth ◽

...

Keyword(s):

Internal Medicine ◽

Quality Improvement ◽

Academic Program ◽

Learning Objectives ◽

Career Intentions ◽

Hospital Leadership ◽

Internal Medicine Residents ◽

Quality Value ◽

Based Medicine

ABSTRACT Background To create meaningful quality improvement (QI) curricula for graduate medical education (GME) trainees, institutions strive to improve coordination of QI curricula with hospital improvement infrastructure. Objective We created a curriculum to teach residents about QI and value-based medicine (VBM) and assessed curricular effectiveness. Methods We designed a 2-week required curriculum for internal medicine residents at a large academic program. After participating in basic skills workshops, trainees developed QI/VBM project ideas with faculty and nonclinical support and pitched them to hospital leaders at the end of the rotation. Pre-post and 1-year follow-up surveys were conducted for residents to self-assess knowledge, attitudes, and skills, participation in QI/VBM projects, and career intentions. We tracked QI/VBM project implementation. Results In the first 2 years (2017–2018), 92 trainees participated, and 71 of 76 (93%) recommended the curriculum. Surveys (76 of 92, 83%) show improvement in our learning objectives (12%–60% pre to 62%–97% post; P < .001 for all; Cohen's d effect size 0.7–1.2), which are sustained at 1-year follow-up (57%–95%; P < .01). Four of 19 projects have been implemented. At 1 year, 95% of residents had presented a quality/value poster presentation, 44% were involved in QI/VBM beyond required rotations, and 26% plan to pursue careers focused on improving quality, safety, or value. Conclusions Our project-based curriculum culminating in a project pitch to hospital leadership was acceptable to GME trainees, improved self-assessed skills sustained at 1 year, and resulted in successfully implemented QI/VBM projects.

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