The main goal of this project is to expand knowledge and skills for pediatricians and residents working in the University Pediatric Hospital emergency room about the recognition and initial management of acute neurological emergencies. 

Quality improvement training during residency allows trainees to develop necessary skills to deliver high quality patient care. The Accreditation Council for Graduate Medical ºÃÉ«ÏÈÉú (ACGME) has recognized the importance to include the competencies of practice-based learning and improvement and system-based practice. Although residents are required to complete QI training, few studies address the optimal curriculum for physicians to incorporate QI learning to future practice. In the University Pediatric Hospital, no uniform protocol for acute neurological emergencies recognition and management has been created, resulting  sometimes in delay of recognition of condition and delay in  treatment to patients.

We designed a QI training program that incorporates PDSA cycles (Plan, Do, Study, Act).  A needs assessment was performed to establish deficiencies in identifying the most common missed acute neurological emergencies diagnoses that require emergent treatment. A pretest was given and then short educational modules were provided to aim the identified deficiencies in the needs assessment. After providing education and training on identification and treatment of acute neurological conditions, a post test was given and modules were redesign depending on the results. 

After PDSA cycles were performed, the diagnoses with most problems to manage were Status Epilepticus, Traumatic spinal cord injury, and  identification of Acute Ischemic Stroke.