Developing a Robust Quality Improvement Curriculum for an Internal Medicine Residency Program

From the 2019 HVPAA National Conference

Dr. Aravdeep Jhand (Creighton University School of Medicine), Dr. Vritti Gupta (Henry Ford Hospital), Dr. Jeffrey Macaraeg (Creighton University School of Medicine), Dr. Venkata Andukuri (Creighton University School of Medicine)


Accreditation Council for Graduate Medical Education requires residents in training programs to participate in quality improvement (QI) projects specifically stating that residents must “work in inter-professional teams to enhance patient safety and improve patient-care quality.” Literature regarding QI curriculum implementation in different residency training programs is limited.


Our objective was to educate residents about tools and strategies that can be used to improve their QI skill set and to assist them in successfully developing and completing QI projects.


A formal QI curriculum was introduced in the Internal Medicine Residency Program of Creighton University at the beginning of 2016-2017 academic session. The curriculum was centered around quarterly faculty led didactic sessions focused on introducing QI methodology and setting up projects using Model for Improvement, data analysis and patient safety concepts. Dedicated QI faculty and champions were identified within each division to provide mentorship to the residents for their projects. The process of designing new projects and implementing interventions was streamlined by creating a standardized dashboard.

During Academic Session 2017-2018, curriculum was expanded to incorporate self-directed learning by providing protected time to residents to complete online interactive Institute for Healthcare Improvement modules. Finally, during the 2018-2019 academic session we introduced a high value care curriculum that aimed at providing residents with strategies and resources to minimize healthcare wastes.


We had close to 35 QI projects led by the residents that were developed during the first academic year. Majority of these projects have completed multiple PDSA cycles. Residents reported improvement in knowledge regarding QI methodology and were more comfortable leading new projects as gathered by results of surveys.


With the implementation of a formal QI curriculum, our residents reported improved QI knowledge and skills setting the foundation for future collaboration in quality improvement processes even after completing residency.

What are academic medical centers across the country doing to improve healthcare value?

Value improvement guides: Published reviews in JAMA Internal Medicine coauthored by experienced faculty from multiple leading medical centers, with safety outcomes data and an implementation blue print.

Review article detailing 25 labs to refine for high value quality improvement | July 2020

MAVEN campaign: Free 4 year high value care curriculum online.

Join the Alliance! Membership is free with institutional approval and commitment to improving value in your medical center.

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