Quality Improvement

Our residents receive longitudinal training in Quality Improvement (QI) throughout their residency. As a part of our QI curriculum, residents learn to evaluate their own practice and examine patient care in a systems-based manner. Our residents are provided "report cards" on their care of patients in their practice panel with diabetes, asthma, heart failure, and coronary artery disease. These reports are reviewed semi-annually with ambulatory faculty mentors. Following this review, the resident develops an action plan for patients at highest risk for poor health outcomes in his/her practice panel.

Our curriculum features a "Quality Improvement Week" during which local and visiting speakers introduce and reinforce concepts of QI and patient safety. Our novel curriculum has been presented on a national scale to other medical educators at the Association of Internal Medicine Program Director’s meeting and the AAMC Southern Group of Educational Affairs meeting.

Residents are divided into QI teams each year. Each team is mentored by a faculty attending with experience in quality and patient safety. In addition, each team receives assistance from a quality improvement coach and/or members of our patient safety department. Each QI team identifies a clinical problem, conducts a root cause analysis, defines an Aim statement, and implements small-scale interventions through multiple PDSA cycles with the goal of improving care.

Each QI group presents their findings to the entire department at our Annual Resident QI Project Presentation Day. In addition, our residents have presented their QI work at the state, regional, and national level.

Recent resident-led QI projects include:

2021

• Stress Ulcer Prophylaxis Quality Improvement Initiative
• Resident Education and Blood Glucose Log Utility
• Improving Medication Reconciliation at Myers Park Clinic
• Improving Screening for Social Determinants of Health
• Improving Covid Vaccination Booster Rates at Myers Park Clinic

2020

• Promoting Medication-Assisted-Treatment for Opioid Use Disorder in the Ambulatory Clinic
• Encouraging Smoking Cessation at Myers Park Internal Medicine Clinic
• Increasing Understanding and Completion of the Care Alignment Tool at Myers Park Internal Medicine Clinic
• Decreasing Inappropriate Measurement of Ammonia Levels in the Inpatient Setting
• Improving Patient Utilization of Dietician Appointments at Myers Park Internal Medicine Clinic

2019

• Bringing Office-based Opioid-Use-Disorder Treatment to Primary Care
• The Butt Stops Here: Increasing Smoking Cessation Counseling at Myers Park Clinic
• Procalcitonin Collection to Facilitate Potential Antibiotic De-escalation
• Increasing Colon Cancer Screening Rates Amongst the Latino Population at Myers Park Internal Medicine Clinic
• Increasing HPV Vaccination Awareness and Usage at Myers Park Internal Medicine Clinic

 2018

• Catch your breath: Increasing Lung Cancer Screening at Myers Park Internal Medicine Clinic
• Wheezing Without Worry: A COPD Power Plan Utilization Project
• Behavioral Health Integration (BHI) Project
• Improving H. Pylori Identification and Eradication
• Increasing the Use of the Sickle Cell Disease Power Plan
• Identifying Food Insecurity in the Outpatient Setting

2017

• Improving Resident Wellness Through Increased Volunteerism
• Improving the Use of Advanced Directives at Myers Park Clinic
• Improving Mammography Screening at Myers Park Internal Medicine Clinic
• Improving Hepatitis C Screening and Linkage to Care
• Examining the Social Determinants of Health at Myers Park Internal Medicine Clinic
• Improving Myers Park Internal Medicine Clinic Phone Line Usage and Care
• Improving Linkage to Early Lung Cancer Screening

2016

• Decreasing Inappropriate PPI Use in the Outpatient Setting
• Increasing Hepatitis C Screening in the Ambulatory Setting (Winner of the departmental top QI project award)
• Improving Resident Comfort and Competency with Inpatient Procedures
• Improving EMR Documentation of the Family and Social History
• “Hopping on the Bus” to Improved Breast Cancer Screening

2015

• Targeting the Use of High Risk Medications in the Elderly at Myers Park Internal Medicine Clinic
• Not Your Typical Smear Campaign: Improving Cervical Cancer Screening at Myers Park Internal Medicine Clinic (Winner of the departmental top overall QI project award)
• Improving Colon Cancer Screening at Myers Park Internal Medicine Clinic
• Improving the accuracy of COPD diagnosis through increasing the use of PFTs

2014

• A Multidisciplinary Effort to Improve Utilization of Resources for Patients with Morbid Obesity in the Primary Care Clinic (Winner of the Most Impactful Project Award at the Atrium Health Senior Resident Leadership Seminar)
• I3POP Collaborative: Improving Diabetic Care in the MPIM Clinic by Increasing Screening for Diabetic Retinopathy (Poster presentation at the North Carolina ACP meeting)
• Improving Physician-Nurse Bedside Rounding and Communication
• Improving Colon Cancer Screening In the Ambulatory Setting
• Don’t Have A Heart Attack: Effective Interventions for Timely Results
• Reducing Hospital Readmissions (Winner of the departmental top overall QI project award)

2013

• I3POP Collaborative: Improving Diabetic Neuropathy Screening at Myers Park Clinic (Winner of the Interdisciplinary Teamwork Award at the Atrium Health Senior Resident Leadership Seminar)
• Improving Cost-Conscious Patient Care Amongst Resident Physicians
• Improving the Hospital Discharge Process with the Goal of Reducing 30-day Re-admissions (Winner of a Bronze Award at the Atrium Health Quality & Sharing Day)
• Improving Primary Care Physician Notification of a Patient’s Admission (Winner of the departmental top overall QI project award)

2012

• Reducing Inappropriate PPI Use in the Hospital (Winner of the departmental top overall QI project award)
• Improving BP Measurement and Management at Myers Park Clinic
• Improving Smoking Cessation Counseling at Myers Park Clinic (Poster presentation at the North Carolina ACP meeting)
• Improving Influenza Vaccination Rates at Myers Park Clinic

2011

• Starting the Discussion: Talking About End-of-Life Care in the Clinic
• Reducing Lab Response Time Amongst Resident Physicians
• Improving Clinical Performance Feedback to Medical Students
• Improving Obesity Recognition and Counseling at Myers Park Clinic
• Increasing Use of Framingham Risk Scoring and Global Risk Assessment at Myers Park Clinic