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projects as a group. Examples of projects included developing an ultrasound
curriculum for the residents, standardizing discharge forms, developing a research
curriculum for research residents, creating a mentoring system between research
residents and surgery interns, and improving resident attendance at the chairman’s
conference. Authors noted that barriers to successful project implementation
included getting the residents to follow through on projects, which was most easy to
do during the residents’ research year when they didn’t have as many competing
clinical demands. The advantage of the approach, however, was that because the
residents were involved in every step of the process, they were invested in the
project’s success.
Tess et al. described their creation of a QI curriculum, which was supplemented
with online modules [ 71 ]. Internal medicine residents at Beth Israel Deaconess
Medical Center (Boston, Massachusetts) were asked to complete a QI project dur-
ing their second year. Residents were grouped into teams of three and asked to use
the PDSA cycle. Their projects targeted quality measures, patient satisfaction,
workflow redesign, and handoff issues. The authors highlighted that implementa-
tion of this QI curriculum improved resident attitudes about the culture of safety and
their perception about the teaching quality of their rotation.
Authors at the University of Wisconsin (Madison, Wisconsin) reported their
experience with the implementation of a practice-based learning and improve-
ment curriculum in PGY-2 general surgery residents. Residents were asked to
select a QI project and then discuss their ideas with two hospital quality improve-
ment staff and the residency program manager to discuss feasibility. The resi-
dents were instructed to use the PDSA model, read several assigned readings,
and attend meetings with the Surgical Quality Improvement Committee,

Plan

Determine a goal

Do

Implement the plan

Study

Evaluate the

outcome

Act

Modify the plan

Fig. 11.2 Plan-do-study-act
cycle

11 The Role of Educators in Quality Improvement