Research + QI

PM&R Quality Improvement (QI)

The PM&R Quality Improvement curriculum was developed for the purpose of facilitating the learning process of in-depth quality improvement project design and implementation. Overall, the curriculum aims to foster a lifelong approach of actively seeking and adopting evidence-based best clinical practices.

Objectives

Promote a culture of patient safety and continuous quality improvement in healthcare

  • Implement safe, efficient, effective, and equitable solutions

Promote evidence based medicine skills

  • Identify institutional clinical issues / outcomes / protocols
  • Define the clinical question
  • Evaluate literature for potential solutions

Promote quantitative clinical improvement skills

  • Design a study to address the question
  • Implement the study
  • Analyze data
  • Refine the study in context of results

Promote national-level academic participation skills

  • Present the study at conferences
  • Publish the study in journals

Program Structure for QI projects

1. What qualifies as a QI project?

A clinical question based upon clinical issues / outcomes /protocols that

  • Directly impact patient care
  • Addressed by SMART (specific, measurable, achievable, relevant, timed) intervention
  • Expected to demonstrate measureable improvement

2. What is the structure of a QI Project?

  • A QI project requires sequential progression through the steps defined below
    • Description – clinical problem, outcomes, protocols
    • Analysis of associated factors and literature review
    • Define SMART goals
    • Planned Intervention
    • Planned Monitoring
    • Implementation and Post-intervention outcomes

3. What comprises a QI team?

  • Resident (s) – maximum of 3 per project
  • Faculty QI mentor (s)
  • Facility staff members, including Risk Management

4. What are the resident expectations for QI projects?

  • Complete at least one QI project
  • Present at the PM&R Resident Research & QI Lecture Series
    • Format – based upon the QI Program Form
    • Initial presentation – Define project
    • Subsequent presentations – Present results, modify project per results
  • Poster presentation opportunities include
    • Institutional – PSQI Symposium, Neurology Resident Day
    • National meetings
  • Complete WashU GME PSQI feedback forms

5. What are some of the additional resources available to residents for the project?

  • WashU GME PSQI Steering Committee
  • WashU PM&R Research and QI team

Research

Residents are encouraged to be involved in at least one research projection during their time at Washington University. During the initial years of residency, residents will identify faculty mentors based upon desired professional expertise within the field of rehabilitation medicine. The faculty mentors will guide the mentored resident through a structured program aimed at developing clinical and research expertise in the resident’s field of interest. The Research/QI Chief Resident and Mentorship Program Director will facilitate the program, including providing assistance for matching residents with mentors, identifying and developing additional resources as needed, coordinating and helping with presentation activities, and monitoring progress.

Typical Progress during Residency Years 1-4

PGY 1-2

  • Identify area of interest and Perform literature review

PGY 2-4

  • Present resident seminar, clinical case conference, and JC on related topics
  • Present research projects, if involved

PGY 3-4

  • Submit clinical case conference to a national journal
  • Present clinical case /resident seminar at national conference
  • Present / publish original research, if involved

Rehab in Review (RIR)

Rehab in Review

Rehab in Review (RIR) is a monthly review journal published through Emory University and the Association of Academic Physiatry (AAP). The journal is comprised of physiatry-relevant publications selected from article summaries authored by PM&R residents from participating residency programs. Selection criteria relate to the relevance of the summary for physiatry and the authoring itself. RIR is distributed nation-wide to all PM&R residency programs.

Each PGY1 submits 1 publication annually, and each PGY 2-4 resident submits 3 publications annually to the Rehab in Review (RIR) Regional Managing Editor, who in turn, helps residents with articles selection, editing, submitting to Rehab in Review. Involvement in this process keeps residents up to date on the most recent physiatric evidence based medicine.