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Conclusions and Future Directions
Quality improvement and patient safety are increasingly important aspects of mod-
ern healthcare systems. Local and national initiatives aimed at improved quality of
healthcare delivery and patient safety result in real-world benefits to patient morbid-
ity and mortality and help to address the rising costs of healthcare. With well-
integrated quality improvement initiatives built into a training curriculum, residents
at academic medical centers are poised to learn the tools necessary to become future
leaders in QI/PS efforts. Medical schools and residencies are in a position to educate
and train the next generation of physicians in QI/PS and to carry on a legacy of high-
quality healthcare delivery.
In surgical education, there are many ways that surgical trainees can participate
in QI/PS projects and educational initiatives. Some of these are outlined in this
chapter and include didactic lectures, local hospital projects, utilizing national data-
base information, participating in morbidity and mortality conferences, utilizing
survey data, and many other possibilities. There are also a number of electronic
resources at the disposal of residents and program directors, many of which are
aimed at QI/PS education.
Although literature review has revealed significant progress from a number of
institutions regarding QI/PS in surgical residency, many institutions lack curricular
organization. Curricular efforts are, for the most part, focused on didactics and to a
lesser extent involve residents in quality improvement projects. In the future, there
is a need for more faculty involvement and educators in QI. Currently accreditation
standards, such as those through the Joint Commission, require that institutions
meet guidelines in order to maintain accreditation. In the future, accreditation stan-
dards may target QI/PS assessments to maintain accreditation.
Examples of Successful Resident-Led QI Projects
There are many examples shared in the literature of successful QI- and PS-related
projects across a wide array of topics. These projects span topics in surgical and
nonsurgical medical specialties. Examples of some topics featured in the literature
are shown in the table below:
Project topic Type Source
Curriculum development of an ultrasound course for the
residentsSurgery Canal et al. (2007)Reducing postoperative order errors Surgery Canal et al. (2007)
Standardizing discharge forms Surgery Canal et al. (2007)
Developing a research curriculum for research residents Surgery Canal et al. (2007)
Improve surgical intern satisfaction with the residency
by creating a mentoring system between research
residents and PGY-1 surgery internsSurgery Canal et al. (2007)Improve resident attendance at the chairman’s
conferenceSurgery Canal et al. (2007)E.L. Ferguson and C.P. Sundaram