Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA.
Mayo Quality Academy, Mayo Clinic, Rochester, Minnesota, USA.
World Neurosurg. 2019 Jun;126:e1112-e1120. doi: 10.1016/j.wneu.2019.02.214. Epub 2019 Mar 14.
Quality Improvement (QI) is essential for improving health care delivery and is now a required component of neurosurgery residency. However, neither a formal curriculum nor implementation strategies have been established by the Accreditation Council for Graduate Medical Education.
We describe our experience with implementing a formal QI curriculum, including structured didactics and resident led group-based QI projects. Course materials and didactics were provided by the Mayo Quality Academy. Participants were required to take a 30-question multiple-choice exam to demonstrate basic proficiency in QI methods following completion of didactic. An anonymous survey also was performed to elicit feedback from course participants.
All of the 40 student participants (17 residents) were able to demonstrate basic proficiency in QI methods on a standardized exam upon course completion. Of the 9 attempted QI projects, 7 were completed, with 5 of those resulting in sustained process changes. The majority of participants felt formal training improved confidence in QI processes and was a valuable professional tool for their careers.
A formal didactic curriculum and practical application of QI methodologies adds value to resident training. Further, it has the potential to positively impact practice. Consideration should be given to adopting a formal QI curriculum by other neurosurgery departments and perhaps standardization on national level.
质量改进（QI）对于改善医疗服务至关重要，现在是神经外科住院医师培训的必备组成部分。然而，研究生医学教育认证委员会尚未制定正式课程或实施策略。
我们描述了实施正式 QI 课程的经验，包括结构化的教学和以住院医师为主导的基于小组的 QI 项目。课程材料和教学由梅奥质量学院提供。参与者在完成教学后，需要参加一个 30 个问题的多项选择题考试，以证明他们在 QI 方法方面有基本的熟练程度。还进行了匿名调查，以征求课程参与者的反馈。
所有 40 名学生参与者（17 名住院医师）都能够在课程结束后的标准化考试中展示基本的 QI 方法熟练程度。在 9 个尝试的 QI 项目中，有 7 个完成，其中 5 个项目导致持续的流程变化。大多数参与者认为，正式培训提高了对 QI 流程的信心，并且是他们职业生涯的宝贵专业工具。
正式的教学课程和 QI 方法的实际应用为住院医师培训增添了价值。此外，它还有可能对实践产生积极影响。应考虑由其他神经外科部门采用正式的 QI 课程，也许在全国范围内进行标准化。
