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Quality Improvement

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.

Innovative Curriculum

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.

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Protected Time to Learn QI


Didactics and Reading


2 weeks

Project selection

  • Problem statement
  • Root cause analysis
  • Background research
  • Propose intervention


2 weeks

  • Implement protocol
  • Rapid cycles of change


4 half-days


  • Conclusions
  • Reflections

Clinical Practice

Lifelong Quality Improvement

Presentation and Writing

Training Residents To Use The Third Bucket

threebucketsMedical 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

moyers_justin_2014MyChart 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

gabehyderDelirium 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

NikolasRobinsGoals 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

gabehyderPartnering 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