M. W. LaPorta1, S. L. Bachman1, P. Graling1, J. Donovan1, H. A. Prentice1, J. M. Dort1, J. J. Moynihan1, H. D. Reines1 1Inova Fairfax Hospital,Department Of Surgery,Falls Church, VA, USA
Purpose:
Recognizing the increased emphasis on quality improvement and patient safety (QI/PS) and the critical role of surgical residents in providing frontline patient care and documentation, we identified the need for a formal chief resident role to oversee QI/PS on the Surgical service.
Methods:
The Chief Resident of QI/PS role was created during the 2014-15 academic year. This Chief served in the role for one year, and was a member of several Department of Surgery and institutional committees. The Chief’s duties included: developing interventions targeted to areas with opportunity for improvement within the department and the institution, as well as overseeing the QI/PS projects required of each surgical resident. The QI/PS Chief created an institution-wide, multidisciplinary Resident QI/PS Committee which reported to the Graduate Medical Education (GME) Committee as well as a formal residency didactic curriculum based on Quality in Training Initiative (QITI).
Results:
At least six successful initiatives were implemented during the inaugural QI/PS Chief year. A required progress note phrase was implemented in the electronic medical record (EMR) to improve Surgical Care Improvement Program compliance. The EMR phrase was modified to improve communication surrounding discharge planning. A treatment team ‘face-sheet’ was deployed to help patients recognize the members of their care team. An early post-operative Colorectal Mobility Initiative was implemented. The Resident QI/PS Committee, comprised of appointed residents, program directors, institutional officials, and the Director of QI/PS, met six times over the year. The agenda included PS events involving residents, best practices across campus, and preparation for the annual campus GME Quality Symposium. A formal didactic for QI/PS curriculum was created based on the ACS NSQIP QITI guidelines. Additionally, we found a significant increase in resident participation in our institutional GME Quality Symposium; participation increased 3-fold after the creation of the formal role.
Conclusions:
The benefits of a QI/PS Chief include: increased participation of surgical residents in developing solutions to improve patient care quality and PS, identification of new QI/PS issues by an active group of providers with established pathways to enact change, and dissemination of QI/PS issues to a surgical residency by a peer group member. During their tenure, QI/PS Chiefs experience personal growth, advanced QI/PS education, and active engagement and involvement in institutional-wide change. In the coming years this formal role will recognize and build upon surgical residents’ influence in improving patient care on an institutional level.