Practice Quality Improvement - The Medical University of South
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Transcript Practice Quality Improvement - The Medical University of South
Practice Quality Improvement:
A Resident Perspective
Madelene 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 learning
Part of Maintenance of Certification (MOC)
PQI Projects
Project with potential to improve the quality of practice
and enhance the quality of care
Should be
Relevant
Achievable
Measurable results
Improve quality
PQI project
Most include six core competencies
Knowledge
Patient care
Communication skills
Professionalism
Practice based learning and improvement
Systems 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 Radiology
Step 1
Identify Problem
Poor and inconsistent communication between the
radiology residents and trauma team after hours
PQI Project Example from Radiology
Step 2
Collect Data
Electronic 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 Radiology
Step 3
Review and Analyze Data
How Trauma Residents Prefer to Communicate?
Page
Call Reading Room
Phone Call
Ibox
Time Expectations for Trauma Reads
100
90
80
70
60
50
40
30
20
10
0
Immediate
5
10
15
20
PQI Project Example from Radiology
Step 4
Develop and implement plan
Meeting with faculty and resident representatives from
trauma and radiology to discuss survey results
Developed new procedure for communication
Policy presented at resident QA conference and monthly
trauma meeting
PQI Project Example from Radiology
Step 5
Reassess and make additional changes as needed
Plan to re-survey radiology and surgery residents 2 months
after the new policy is implemented
Conclusion
PQI projects are important to residents
Practice for future MOC requirement
Improves patient care
Engages residents
Motivates faculty