Are You QI Cool?

By Michael Kantrowitz, DO (Guest Author and Chief Resident, Maimonides Medical Center)

It seems that there is a growing number of residents out there who are.

This past weekend, the Committee of Interns and Residents (CIR) hosted an event called “What’s Your QI IQ? Resident Physicians as Quality Improvement Leaders” in New York City. The program was developed as a partnership between the CIR Policy and Education Initiative and the Healthcare Transformation Project of Cornell University.

The day kicked off with introductions by Dr. Svjetlana Lozo, an ob/gyn resident from Maimonides Medical Center in Brooklyn and Dr. Rick Gustave, an emergency medicine resident at Lincoln Hospital in the Bronx. They described the push towards improved quality, safety, and transparency in medical practice and the central role that residents are beginning to play in leading that charge. Next up was Dr. James Pelegano who is an assistant professor and director of the master’s program in healthcare quality and safety at the Jefferson School of Population Health. Dr. Pelegano discussed his own experience in quality improvement in practice as a neonatologist. He then led us in a root cause analysis exercise using the recent death of Rory Staunton, a pediatric patient who succumbed to sepsis as case example.

Breaking into small groups, we were asked to take on various roles of the multidisciplinary team members who were involved to try to identify the contributing factors that led to the delayed recognition of Rory’s ultimately fatal illness. Many residents had never participated in a root cause analysis before, which sparked much discussion over the clinical and communication issues that could be improved. Dr. Pelegano challenged us to think like a hospital’s administration and find a process improvement that could be implemented within two days. He also discussed tools such as flow charts, Ishikawa diagrams, and PDSA cycles which we could add to our arsenal.

We then heard from three residents at CIR represented hospitals who discussed projects they have worked on at their institutions.

  • Dr. Constance Liu, an ob/gyn resident at Boston Medical Center, discussed efforts to improve resident education and adverse event reporting. Residents at her hospital have received a grant for this work.
  • Dr. Sepideh Sedgh, a pulmonary/critical care fellow, described the work that residents at Maimonides Medical Center have done as part of a joint quality partnership between CIR and the administration. Residents, including myself, took on the task of significantly improving the medication reconciliation process to make patient discharges safer
  • Finally Dr. Say Salomon an internal medicine resident from Woodhull Medical Center explained how their House Staff Safety Council has been enhancing patient care. One project he talked about was a resident-led program to reduce heart failure readmissions through better patient education.

The day ended with an interactive discussion run by Jennifer Weiss, a public health consultant with SAE & Associates. She led a workshop on developing and writing quality improvement and patient safety grant proposals using our own ideas for projects. I plan on using these skills as I look to find funding for future projects of my own.

It’s safe to say that we all left with a boost to our QI IQ and I’m looking forward to more events like this, which will train and challenge our generation of physicians to improve quality and safety.

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