ACGME Committee on Innovation’s new report on residents and quality improvement

By: Julie McCoy September 19th, 2008

The ACGME Committee on Innovation released its new report earlier this week titled, Involving Residents in Quality Improvement: Contrasting “Top Down” and “Bottom-Up” Approaches.

The report looks at the differences between institution-led and program-led quality improvement initiatives.

Seeing this report got me thinking about an article I read recently that said the term ‘residents’ evolved years and years ago because physicians-in-training used to basically live at the hospital- they were always there. Even with today’s duty hour limitations, residents still spend a ton of time in hospitals. Because they spend countless hours roaming the wards, they get to know the ins and outs of the hospital pretty well.

Additionally, while hospital systems typically suffer from a silo effect in which each department operates on its own, residents have the unique opportunity to travel across departments. Because residents spend so much time in the hospital and get to see what’s happening across the institution, they are able to better recognize system problems .

I’ve interviewed several people for Residency Program Alert, who say it’s imperative to have residents at the center of quality improvement initiatives. Not only does it meet the competencies of systems-based practice and practice-based learning and improvement, it also helps better patient care.

What quality improvement projects have residents in your program developed? What impact, if any, have they had on the program or the hospital as a whole?