Educating for Quality: Quality Improvement as an Activity of Daily Learning to Improve Educational and Patient Outcomes

Abstract

THE QUALITY OF care delivered to children is suboptimal, with opportunities for improving quality and value across care settings and conditions. Leading health care organizations have recognized that quality improvement (QI) should play a vital role in improving the quality of care delivered to all populations, including children. For this strategy to succeed, all health professionals, including physicians, should become proficient in QI. Recognizing the need for widespread and dramatic improvements in health care delivery systems, the American Board of Pediatrics (ABP) designed their program of Maintenance of Certification to include that all diplomates must at a minimum be active participants in critically analyzing and improving the care of the patients they care for. Most recently, the Accreditation Council for GraduateMedical Education (ACGME) developed specific milestones for competencies related to QI and instituted the Clinical Learning Environment Review (CLER) Program to help identify and disseminate best practices on how residents and fellows can become better engaged in institutional safety and QI to enhance their training while simultaneously improving care for the patient populations they care for. What is the state of QI education in pediatric graduate medical education?Mann et al conducted a survey to better understand the perspective of pediatric residency program directors. In recent years, an increasing proportion of program directors report providing education in QI, and that curricula typically include several elements conducive to learning QI, including an experiential component. Program directors reported a variety of process improvement methodologies as the basis of their curriculum. However, only a minority of resident QI projects had support for project management. As institutional resources become more constrained, it will become even more challenging to support QI in areas that are exciting to trainees but are not aligned with institutional priority areas. Only a minority of program directors reported being satisfied with their QI curricula.