Supporting Resident-Led Quality Improvement Through a Novel Visual Board (QI Abstract)

The ACGME CLER Pathways to Excellence promotes resident engagement in quality improvement (QI) activities. However, infrastructure to capture problems that residents encounter as frontline caregivers can be sub-optimal. Empowering residents to engage in problem resolution may be further challenged by a lack of a reliable process to solve these problems. Aim Statement Implement a resident-led quality improvement visual board at Lucile Packard Children’s Hospital Stanford by August 2016 and increase resident problem reporting and resolution by 25% by the end of the academic year. Interventions In August 2016, a QI problem reporting visual board was placed in the residency common space for residents to report QI issues in four main categories (Figure 1). Residents received a 45-minute QI education session introducing the visual board. Problems were written on the board and also submitted electronically. Chief residents reviewed and responded to all submissions weekly, utilizing their knowledge of the local hospital system to guide residents towards problem resolution. Resident-identified QI issues were also discussed at weekly multidisciplinary leadership rounds and monthly residency council meetings. Measures Primary outcomes were changes in pre vs. post-intervention number, characterization and outcome of problems reported. A run chart was used to track progress. Secondary outcomes were pre vs. post QI knowledge and confidence, assessed by surveys.