Carek Peter J, Dickerson Lori M, Stanek Michele, Carter Charles, Godenick Mark T, Jebaily Gerard C, Sprague Stuart, Baxley Elizabeth
J Grad Med Educ. 2014 Mar;6(1):50-4. doi: 10.4300/JGME-06-01-39.1.
Quality improvement (QI) is an integral aspect of graduate medical education and an important competence for physicians.
We examined the QI activities of recent family medicine residency graduates and whether a standardized curriculum in QI during residency resulted in greater self-reported participation in QI activities in practice after graduation.
The family medicine residency programs affiliated with the South Carolina Area Health Education Consortium (N = 7) were invited to participate in this study. Following completion of introductory educational activities, each site implemented regularly occurring (at least monthly) educational and patient care activities using QI principles and tools. Semiannually, representatives from each participating site met to review project aims and to provide updates regarding the QI activities in their program. To examine the impact of this project on QI activities, we surveyed graduates from participating programs from the year prior to and 2 years after the implementation of the curriculum.
Graduates in the preimplementation and postimplementation cohorts reported participating in periodic patient care data review, patient care registries, QI projects, and disease-specific activities (57%-71% and 54%-63%, respectively). There were no significant differences in QI activities between the 2 groups except in activities associated with status of their practice as a patient-centered medical home.
Most but not all family medicine graduates reported they were actively involved in QI activities within their practices, independent of their exposure to a QI curriculum during training.
质量改进(QI)是毕业后医学教育的一个重要组成部分,也是医生的一项重要能力。
我们研究了近期家庭医学住院医师毕业生的质量改进活动,以及住院期间标准化的质量改进课程是否会使毕业生在毕业后的实践中更多地自我报告参与质量改进活动。
邀请南卡罗来纳地区健康教育联盟附属的家庭医学住院医师项目(N = 7)参与本研究。在完成入门教育活动后,每个站点使用质量改进原则和工具开展定期(至少每月一次)的教育和患者护理活动。每个参与站点的代表每半年会面一次,审查项目目标并提供其项目中质量改进活动的最新情况。为了研究该项目对质量改进活动的影响,我们对课程实施前一年和实施后两年参与项目的毕业生进行了调查。
实施前和实施后队列的毕业生报告参与了定期的患者护理数据审查、患者护理登记、质量改进项目和特定疾病活动(分别为57%-71%和54%-63%)。两组之间在质量改进活动方面没有显著差异,除了与以患者为中心的医疗之家的实践状态相关的活动。
大多数但并非所有家庭医学毕业生报告称,他们在实践中积极参与质量改进活动,这与他们在培训期间是否接触过质量改进课程无关。