Quality Improvement Project

Program Overview

The UNC Pediatric Residency Quality Improvement (QI) Program is designed to help prepare pediatricians to address quality of care issues during their training and career. The program is aligned with the Pediatric Residency Review Committee requirement that all residents learn QI methods and participate in a QI project during their residency.

The QI Program assures that all residents:

Participate in at least one QI project during their residency,

Have access to a knowledgeable QI faculty advisor to assist them with their project,

Understand the important role of physician leadership in QI efforts, and

Understand and can perform the basic steps of a QI project:

Select area for improvement

Write project aim with measurable goals

Test and implement system changes using plan-do-study-act (PDSA) cycles

Understand how to use seven basic quality tools

Measure process and outcome changes using the basic quality tools

QI Program Requirements

Meet with selected QI faculty advisor at least twice (once at the beginning to discuss the project and develop a plan and once during the closeout)

Complete all required readings and IHI modules

Select QI project and submit application for IRB approval

Conduct QI project

Submit final report to selected QI faculty advisor and the QI program manager

Recommended Timeline for QI Project Requirements

January - June of PL-2 Year

Select a project to join or create your own project

Contact a faculty member to serve as advisor

Submit application for IRB approval

Most QI projects are exempt from IRB approval, but it is still necessary to complete this IRB form. Once the application is submitted, it takes less than 10 business days for approval. Your QI faculty advisor can provide you with examples of IRB.

Required readings

July - December of PL-3 Year

Conduct QI project

January - February of PL-3 Year

Complete final report and submit to faculty advisor and Kelly Lear (klear@med.unc.edu)

February - April of PL-3 Year

Prepare Poster for Evening of Scholarship (optional)

May of PL-3 Year

Present QI Project at Evening of Scholarship (optional)

Required Readings and Resources

Aim Statement Worksheet

PDSA Cycle Template

Final Report Template

IHI Modules

Register for free and complete the following courses:

QI 102: Model for Improvement - Your Engine for Change: Lessons 1, 2, and 3

QI 103: Measuring for Improvement: Lesson 2

Batalden P, Davidoff F. Teaching quality improvement: the devil is in the details. JAMA. 2007 Sep 5;298(9):1059-61.

Reinertsen JL. Physicians as leaders in the improvement of health care systems. Ann Intern Med. 1998 May 15;128(10):833-8.

Langley, G., Nolan, K., Norman, C. L., Provost, L., & Nolan, T. (1996). The Improvement Guide: A practical approach to enhancing organizational performance. New York, NY: Jossey-Bass.

Chapter 1

Chapter 2

Chapter 3

Chapter 4

Chapter 5

Chapter 6

Tague, N. (2005). Quality Toolbox (2nd ed.). Milwaukee: ASQ Quality Press. Read the following sections: check sheets, fishbone diagrams, flow charts, histograms, pareto charts, run charts , and scatter diagrams.

PDSA Cycles Slideshow

QI Methods Slideshow

Current and Past Projects

Current Projects:

Marquita Genies, Stevie Rowe and Emily Vander Schaaf: Improving MDI Spacer Use in a General Pediatrics Clinic

Andrew Heling, Mary Currie and Melissa Cabellon: Inpatient Treatment of Community Acquired Pneumonia in Children

Jenn Stiff: Car Seat Education in the Newborn Nursery

Andrew Heling: Usage of Supplemental Prenatal Counseling Tool in Counseling Expectant Parents of Very Premature Babies

Jackie Patterson: Communication Between Pediatrics and Obstetrics Regarding Maternal Diagnosis of Chorioamnionitis

Class of 2013 Projects:

Mark Connelly and Dan Lercher: Use of the Physician Portal to Improve Asthma Care

Natalie Austin: Improving the Conversation about Attaining a Healthier Lifestyle

Ginger Locklear and Kasey Joyner: Keeping Up With Kids - Improving Anticipatory Guidance for the School Age Child

Steven Pattishall: Laptops and Electronic Resources to Improve the Pediatric Resident's Continuity Clinic Experience

Krystle Perez: Linking the Newborn Nursery and Resident Clinic: The Key to Continuity Success?

Nick Potisek: The Use of Spirometry in Patients with Asthma in the UNC Pediatric Continuity Clinic

Kristen Rogers and Elizabeth Tucker: Improving Resident Documentation of Pediatric Obesity in Continuity Clinic

Rebekah Savage: Substance Use Screening in Adolescents

Megan Speare: Postpartum Smoking Cessation

Cara Cannon: New Lab Reporting System in the Continuity Clinic

Pinar Gumus: Is Chronic Disease a Risk Factor for the Adolescent Driver?

Christy Hanofee: Use of TeamSTEPPS to improve communication during mock code scenarios

Beth Turney and Priti Elkins-Williams: Wait 48: Reducing Readmission Rates for Late Preterm Infants

Class of 2012 Projects:

Jaya Barina: Guidance at the First Newborn Visit in Continuity Clinic

Erica Bartelt: MCHAT in Spanish

Mary Boruta: E-Scripts

R.J. Boruta: E-Scripts

Theresa Kallman: Rapid Response System

Kelly Kimple: MCHAT in Spanish

Joseph Powers: Adolescent PPE on Saturdays

Jennifer Rochette: Guidance at the First Newborn Visit in Continuity Clinic

Rhiannon Smith: Curriculum Advancement by Implementing a Critical Care Lecture Series with Simulation

Ashley Sutton: Call Backs in Clinic

Thomas Sutton: Call Backs in Clinic

Jennifer Vincent: Creating a Cocoon of Protection: Tdap Vaccination for Caregivers of Newborns at UNC Pediatric Resident Clinic

Lindsey Wilfley: Continuity in Clinic

Class of 2011 Projects:

Christy Anderson: Preventing Readmission Rates for Hyperbili by Educating Physicians and Using a Standardized Method of Checking and Assessing Bilirubin

Ryan Barbaro: Newborn Drug Screening Protocol

Justin Godown: Optimizing Efficiency in General Pediatric Clinic

Caroline Hobbs: Educational Intervention for Improving Asthma Management

Yemisi Jones: The Impact of an Otitis Media Outpatient Training Program on Resident Performance

Meg Kihlstrom: Crowd Control During PRRT

Matt Lewis: Improving the Quality of Discharge Communication with an Educational Intervention

Tim Moran: Educational Intervention for Improving Asthma Management

Lindsey Murphy: Facilitating Communication to Improve the Quality of Care in the North Carolina Children’s Hospital

Chrystal Rutledge: Using Visual Aid to Improve the PICU Transfer Process

Nicole Sammons: Facilitating Communication to Improve the Quality of Care in the North Carolina Children’s Hospital

Angie Scott: Optimizing Efficiency in General Pediatric Clinic

Zeb Spector: Enhancing Resident Education in Evidence Based Medicine

Liz Thompson: Crowd Control During PRRT

Six Valdelievre: Pain in Children's Hospital; Which Intern Do I Page?; and Asthma Medications and Illiteracy