Practice Quality Improvement: A Resident Perspective Madelene Lewis, MD Radiology Resident, PGY-4...
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Transcript of Practice Quality Improvement: A Resident Perspective Madelene Lewis, MD Radiology Resident, PGY-4...
Practice Quality Improvement: A Resident
PerspectiveMadelene Lewis, MD
Radiology Resident, PGY-4
Medical University of South Carolina
What is PQI?Practice quality improvement
Why PQI?American Board of Specialties
response to public concerns Promotes continuous quality
improvement and lifelong learningPart of Maintenance of Certification
(MOC)
PQI Projects
Project with potential to improve the quality of practice and enhance the quality of care
Should beRelevantAchievableMeasurable results Improve quality
PQI project
Most include six core competenciesKnowledgePatient careCommunication skillsProfessionalismPractice based learning and improvementSystems based practice
Resident Learning Portfolios
ACGME now requires
Based on 6 core competencies
PQI projects address practice based learning and improvement “Systematically analyze practice using quality
improvement methods and implement changes with the goal of practice improvement”
PQI and Residents
Now a resident requirement
Projects can be local, institutional, or society based
Why PQI in residency?
Opportunity to become familiar with PQI
Proactive environment
Develop tools to resolve problems
Improves patient outcomes
Increases resident engagement and satisfaction
Involves faculty and other team members
Resident Support
Effective quality improvement curricula
Departmental role models and mentors
Infrastructure embeds quality improvement in daily practice
Increase appeal to residents and faculty
How to do a PQI project?
Select Project: Identify an existing or potential issue
Collect Data
Review and analyze data
Develop improvement plan
Incorporate proposed solution
Reassess to determine success
Identify and institute additional strategies or changes
Examples of project types in radiology
Patient safety
Accuracy of interpretation
Report turnaround time
Practice guidelines and technical standards
Referring physician surveys
PQI Project Example from RadiologyStep 1
Identify ProblemPoor and inconsistent communication between the
radiology residents and trauma team after hours
PQI Project Example from RadiologyStep 2
Collect DataElectronic survey sent out to all radiology and
surgery residents regarding radiology communication on trauma patients
1. How do the radiology residents currently communicate preliminary trauma reads after hours?
direct phone call 50.0%
Pager 30.0%
Ibox 30.0%
you must call the reading room 90.0%
2. How do you think radiology residents should communicate preliminary reads on trauma victims after hours?
Direct phone call 40.0%
Pager 30.0%
Ibox 10.0%
I prefer to call the reading room 40.0%
3. How quickly do you expect a preliminary read on trauma victims after hours?
Immediately 20.0%
25 minutes 0.0%
10 minutes 30.0%
15 minutes 50.0%
20 minutes 0.0%
30 minutes 0.0%
PQI Project Example from RadiologyStep 3
Review and Analyze Data
PageCall Reading RoomPhone CallIbox
How Trauma Residents Prefer to Communicate?
Time Expectations for Trauma Reads
01020304050
60708090
100
Immediate 5 10 15 20
PQI Project Example from RadiologyStep 4
Develop and implement planMeeting with faculty and resident representatives
from trauma and radiology to discuss survey resultsDeveloped new procedure for communication Policy presented at resident QA conference and
monthly trauma meeting
PQI Project Example from RadiologyStep 5
Reassess and make additional changes as neededPlan to re-survey radiology and surgery residents 2
months after the new policy is implemented
Conclusion
PQI projects are important to residentsPractice for future MOC requirement Improves patient careEngages residentsMotivates faculty