Quality Improvement

Quality ImprovementContinuous quality improvement (CQI) has become an increasingly important part of the health care industry, both in patient care and in education. A recent national policy statement from the Institute of Medicine urges physicians to take the lead in improving the quality of the U.S. health care system. Resident participation in CQI is required by the ACGME under the competency of “practice-based learning and improvement”. In addition, the American Board of Pediatrics requires a Quality Improvement project for recertification. Given this new emphasis, we have developed a robust QI program that spans all three years of residency.

By the completion of residency, our residents should be able to demonstrate the knowledge and skills necessary to effectively participate in a CQI effort and demonstrate an appreciation for the need to improve quality in health care. This program utilizes the following components:

Online Training Modules

Several on-line training modules, ranging from the basics of CQI to a more “graduate” level, are available by iPad or other internet-connected devices.

Interactive Discussion Session

This workshop occurs at the end of intern year, and includes a review of the residency CQI program. It allows for an interactive discussion of QI concepts and brainstorming to generate ideas for potential QI projects.

QI Project

Quality Improvement 2Residents are required to participate in a CQI project. These projects are collaborative and interdisciplinary in nature. They build teamwork skills and foster a sense of inquiry and personal responsibility for overall healthcare for our patient population. Residents can do short (a few months) or long-term projects in groups with other residents, faculty, hospitals, etc. All residents must complete a project by the end of their third year. Graduating seniors must present their projects in poster or oral format during an annual scholarly projects forum their senior year. Projects may also be presented at a regional pediatrics conference in the spring of each year and at Grand Rounds. Many may rise to the level of publication in peer-reviewed journals.

2015 Resident QI Projects

  • “Handbook on How to Make the ER Rotation Better”, by Dennrik Abraham, Lauren Friedman, Jordan Larsen
  • "Improving Resident Participation and Perception of Board Review”, by Kathleen Altemose, Kelly Driver, Isabel Gross, Katherine Guthrie, Erin Wright
  • “Improving the Heme/Onc Educational Experience for Residents at TGH”, by Kristi George, Yolanda Suarez, Erin Wright
  • “Medication Adherence in Rheumatology Clinic”, by Miriah Gillispie and Sara Sabbagh
  • “Increasing Continuity in Continuity Clinic”, Kelly Driver and Katherine Guthrie
  • “Formative Work towards Developing an Innovative STI and Unintended Pregnancy Risk Reduction Intervention Among Young, High-Risk Women”, by Cameron Nereim
  • “Participation in National NPAI HPV study, part of CORNET research group”, by Drs. Gao, Baldwin, Kickish and Rietsma
  • “Asthma Study”, by Drs. Dalsania and Lastra
  • “Implementation of a Spanish Training Curriculum in a Pediatric Residency Program”, by Drs., Nguyen, Perez and Luna
  • “Social Determinants of Health”, by Drs. Rietsma and Robles

2014 Resident QI Projects

In the Spring of 2014, a Pediatric Grand Rounds was devoted to resident projects. Residents presented five diverse presentations:

  • “Increasing Continuity in Resident Clinic” presented by Drs. Christine Boot and Kelly Driver
  • “Implementation of a Resident Resource to Facilitate and Improve Residents’ Experiences in the Pediatric Intensive Care Unit” presented by  Drs. Marsha Ramsay, Pooja Soni, Prachi Singh,
  • “Rates of Remission in Polyarticular JIA: A Practice-Based Study” presented by Mariah Gillispie
  • “Asthma Control Test Documentation in Asthma Patients” presented by Dr. Alisha Pineiro
  • “Neonatal Abstinence Syndrome Management: A Quality Improvement” presented by Drs. Jacqueline Nguyen and Kim Chau

At the Annual Lewis Barness Fellows Forum in April 2014, pediatric residents presented their QI projects and other research projects during a poster presentation: 

  • “Asthma Control Test Documentation in Asthma Patients” presented by Dr. Alisha Pineiro
  • “Interventions to Improve Medication Compliance in Rheumatologic Chronic Disease” presented by Drs. Miriah Gillispie and Beth Shipman
  • “Increasing Continuity in Resident Clinic” presented by Drs. Christine Booth, Philip Matar, Gina Nguyen, Katherine Trotter, Fateema Turray, Kelly Driver
  • “Improving the Identification of Bullying in School-aged Children” presented by Drs. Glivery Gayahan and Shaila Siraj
  • “Neonatal Abstinence Syndrome Management: A Quality Improvement” presented by Drs. Jacqueline Nguyen and Kim Chau
  • “Social Determinants of Health” presented by Drs. Kevin Whitworth, Kristine Rietsma and Joanna Nico
  • “Improving Resident Participation and Perception of Board Review” presented by Drs. Krista Kohout, Sara Saporta,  Noah Grams, Lisa Hayes, Erin Wright
  • “Implementation of a Resident Resource to Facilitate and Improve Residents’ Experiences in the Pediatric Intensive Care Unit” presented by Drs. Marsha Ramsay, Pooja Soni, and Prachi Singh

2013 Resident QI Projects

2013 Pediatric Grand Rounds presentations:

  • “Food Insecurity and Children”  and  “Patient Centered Medical Home: Patient Satisfaction Survey” both presented by  Dr. Catherine Baker
  • “Pilot Study: Understanding Parental Perceptions of Children’s Body Image, Health, and Dietary Intake in Panama” presented by Drs. Katherine Byra and Matias Jasin
  • “Improving Compliance with ACGME Resident Duty Hour Rules” presented by Dr. Cary Aungst
  • “Addressing Infantile Pertussis” presented by Drs. Deanna Barry
  • “Patient Centered Medical Home:  Patient Satisfaction Survey” by Dr. Melanie Youschak and Dr. Catherine Baker. 

2013 Annual Lewis Barness Fellows Forum:

  • “ Effect of utilization of post-call badges on improvement in timely departure of post-call residents”  by Drs. Cary Aungst, Catherine Kubiak, and Kelly Montgomery
  • “Impact of a community coalition addressing food insecurity in children” by Dr. Mary Baker
  • “Effect of implementation of a tier system on pain control in the CVICU” by Dr. Krystle Balduzzi
  • "Addressing infantile pertussis: The effect of adding Tdap immunization status questions to well visit chart templates and providing informational handouts to families” by Drs. Deanna Barry, Haley Howard, and Kelly Driver
  • “Implementation of a Spanish language training curriculum in a pediatric residency program” Drs. Pilar Brinez, Juan Luna, Vanessa Perez, and Yolanda Suarez
  • “Knowledge, attitudes, and practices related to obesity in Panama” by Drs. Katherine Byra, Matias Jasin, Vanessa Perez, Christina Dornschuld, and Kim Chau
  • “Enhancing quality of care for ADHD patients” by Dr. Mary Chrisochos
  • “Feasibility and safety of rapid refeeding of hospitalized anorexic patients” by Drs. Stacey Keller and Fateema Turay
  • “Resident education in the NICU” by Drs. Richard Lion and Haley Howard
  • “Effects of implementation of a hypertonic saline protocol for RSV bronchiolitis” Dr. Scott McKinley
  • “Implementation of a specific care template for children in foster care” by Dr. Dayna Moore
  • “Update and revision of the newborn manual for pediatric residents” by Dr. Mindy Murphy
  • “Improving conscious sedation and pain management for abscess incision and drainage” by Dr. Erika Pasciuta
  • “Cardiac screening prior to cardiothoracic surgery in neonates” by Drs. Anthony Sochet and Katherine Braley
  • “Implementation of a medical home project” by Drs. Melanie Youschak and Mary Baker