Eden Elizabeth L, Harrington Terence, Chen Ling-Wan, Chelluri Lakshmipathi, Higgins Linda W, Freel Jennifer A, DeKosky Allison, Bump Gregory M
J Healthc Qual. 2020 Jul/Aug;42(4):e50-e57. doi: 10.1097/JHQ.0000000000000258.
Nationally, there is an expectation that residents and fellows participate in quality improvement (QI), preferably interprofessionally. Hospitals and educators invest time and resources in projects, but little is known about success rates or what fosters success.
To understand what proportion of trainee QI projects were successful and whether there were predictors of success.
We examined resident and fellow QI projects in an integrated healthcare system that supports diverse training programs in multiple hospitals over 2 years. All projects were reviewed to determine whether they represented actual QI. Projects determined as QI were considered completed or successful based on QI project sponsor self-report. Multiple characteristics were compared between successful and unsuccessful projects.
Trainees submitted 258 proposals, of which 106 (41.1%) represented actual QI. Non-QI projects predominantly represented needs assessments or retrospective data analyses. Seventy-six percent (81/106) of study sponsors completed surveys about their projects. Less than 25% of projects (59/258) represented actual QI and were successful. Project category was predictive of success, specifically those aimed at preventive care or education.
Less than a quarter of trainee QI projects represent successful QI.
Hospitals and training programs should identify interventions to improve trainee QI experience.
在全国范围内，人们期望住院医师和研究员参与质量改进（QI），最好是跨专业参与。医院和教育工作者在项目上投入了时间和资源，但对于成功率或促成成功的因素却知之甚少。
了解实习医生质量改进项目的成功比例以及是否存在成功的预测因素。
我们研究了一个综合医疗系统中的住院医师和研究员质量改进项目，该系统在两年内支持多家医院的多样化培训项目。对所有项目进行审查以确定它们是否代表实际的质量改进。根据质量改进项目发起人的自我报告，被确定为质量改进的项目被视为已完成或成功。比较了成功项目和未成功项目的多个特征。
实习生提交了258份提案，其中106份（41.1%）代表实际的质量改进。非质量改进项目主要是需求评估或回顾性数据分析。76%（81/106）的研究发起人完成了关于他们项目的调查。不到25%的项目（59/258）代表实际的质量改进且取得了成功。项目类别可预测成功，特别是那些针对预防保健或教育的项目。
不到四分之一的实习医生质量改进项目代表成功的质量改进。
医院和培训项目应确定干预措施，以改善实习医生的质量改进体验。
