At Providence St. Vincent, we know that physicians of the future must actively shape our healthcare system to deliver better care and better outcomes, all at a lower cost. Quality improvement requires unique skills that can't be taught in a lecture -- project management, team leadership, persistence, and passion. We support each resident to lead a project, following a structured process to implement, test, and measure change.
Our innovative three-year curriculum has been presented at the Annual Program Directors in Internal Medicine meeting with an accompanying publication in Academic Internal Medicine Insight.
Because making real system level changes and measuring their effects takes time, our curriculum is spread over the three years of residency. Two-week QI rotations are built into both the PGY-1 and PGY-2 years, with several half-days during the PGY-3 year as well. This protected time plus experienced mentors and access to our own data analyst helps residents produce and measure meaningful healthcare improvement.
Mentorship
Didactics and Reading
2 weeks
Project selection
2 weeks
Implementation4 half-days
Results
Lifelong Quality Improvement
Presentation and Writing
Medical school teaches the first two “buckets” of medicine:
pathophysiology and treatment of disease. We teach our residents the third
bucket: quality improvement. We create systems to do what works, every
time, for every patient.
“I love the moment when I see the light shining in their eyes. Their
face gets animated as they talk about where the project could go, and
I know we've found their passion.”
Shelley Sanders, M.D., FACP | Director of Quality Improvement Curriculum and Fellow, Innovation Advisors
Program, Centers for Medicare and Medicaid Innovation
MyChart Outreach to the Vaccine Hesitant
“I learned how to use Tableau to manage data, create grafts, and
share this information with my team. I feel like the hard work of my team
culminated in tangible product that shed light on an important aspect
of medicine.”
Nate Edwards, MD | Providence Hospitalist, Class of 2023
Delirium Reduction through Music on the Accountable Care Unit
“The value of stakeholder interviews has been solidified for me because
of the work I did in QI. I would go to my nursing colleagues, who were
an integral part of my project, in every phase of my work. Engaging stakeholders
on a continuous basis allows a QI project leader to adjust the protocol
to best serve its target population, maintain alignment with project aims
and increase the chances of success.”
Nick Gates, MD | Chief Medical Resident, PSVMC Residency, Class of 2023
Goals of Care Documentation with Attention to Equity in Use of Interpreters
“We analyzed the patient population by their primary language as
well as ethnicity to ensure that goals of care conversations are taking
place with patients from all backgrounds. Thankfully we found that Spanish
speaking patients and people of color were having goals of care documented
at a similar rate to patients who were White and English-speaking. I am
proud that we had such a large increase in percent of seriously ill patients
with documented goals of care. I am confident that many of these patients
either have or will avoid unwanted life prolonging medical care that is
often quite painful.”
Wiley Harkens, DO | Endocrine Fellowship-UC Irvine, Class of 2023
Partnering with ED Providers to “Read” Goals of Care Notes
Written by Other Providers
“I learned . . . how to make a "short but impactful" survey
that hopefully provided information and also encouraged more use of the
tool.”
Karissa Kunihira, MD | Providence Hospitalist, Class of 2023
