To increase resident participation in quality improvement (QI) in a large New York City neurology residency program within a one-year academic period.

The ACGME requires that neurology residents receive training and experience in quality improvement processes (QI). QI involves investigating root cause analysis and systems thinking. As part of preparing future clinical leaders, residency programs educate residents on ways to analyze the care they provide, investigate system process, and understand their roles within the larger health care system. There is a need to guide residency programs to further develop and improve resources to encourage resident involvement in QI. We present a possible solution to increase QI education and participation among our neurology residents.

Well-established QI tools including driver diagrams, cause and effect diagrams and GEMBA walks were utilized to identify barriers and tests of change. We then designed and implemented a multifaceted approach to achieve our objective including (1) creation of a database tracking ongoing projects, (2) establishment of a department mandate regarding resident participation in quality improvement, (3) administration of QI didactic lectures, and (4) increased visibility of QI projects through departmental social media and grand round QI presentations. Resident project participation was our primary outcome measure, and tracked through the database.

Second year neurology resident QI project participation increased from 36% to 100%, third year resident participation increased from 70% to 90%, and fourth year residents maintained their high level of participation with 88% participating in QI and two residents were exempt.

Our approach to increasing neurology resident participation in quality improvement projects was successful. At our institution, QI has gained recognition as a critical component of our residents’ scholarly activity.