To improve resident satisfaction and comprehension of QI concepts by implementing a new neurology residency quality improvement (QI) curriculum.

The Mayo Clinic neurology residency runs a yearly QI course involving a didactic series and resident-led QI projects. Overall resident satisfaction has been modest. A root cause analysis revealed poor resident participation, comprehension, and engagement due to outdated teaching techniques and a lack of multidisciplinary involvement disconnected from clinical practice.

The QI course was re-designed and utilized the AAN NeuroLearn: Patient Safety module. Concepts from this module were incorporated into real time clinical projects. We measured resident satisfaction and comprehension on a 5-point Likert scale using pre- and post-course surveys to assess level of understanding and comfort with QI concepts and number of active and completed resident-lead QI projects over the 2019-2020 academic year (pre-intervention n=42, post-intervention n=9). To address the disconnection from clinical practice, a resident lead Neurology QI committee was created to identify QI needs in the inpatient setting. This committee also acted as a liaison to the existing neuroscience multidisciplinary hospital practice committee.

Residents were better able to describe QI methodology (4.4 versus 3.7, p = 0.019), identify opportunities for improvement (4.3 versus 3.6, p = 0.032), apply QI tools and methods (4.1 versus 3.4, p = 0.016), and discuss strategies for sustainable improvement (4.1 versus 3.5, p = 0.041) after intervention. The number of active QI projects also increased after intervention (8 versus 3).

QI can be taught to residents in an effective manner, and residents can in turn provide a valuable role in identify, analyzing, and implementing QI projects. We can provide future clinicians with the skills to readily identify quality gaps and create a culture of excellence that will help patients, families, and institutions flourish.