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. 2014 Sep;6(3):541-6.
doi: 10.4300/JGME-D-14-00016.1.

A Novel Approach to Practice-Based Learning and Improvement Using a Web-Based Audit and Feedback Module

Joel C Boggan, George Cheely, Bimal R Shah, Randy Heffelfinger, Deanna Springall, Samantha M Thomas, Aimee Zaas, Jonathan Bae

A Novel Approach to Practice-Based Learning and Improvement Using a Web-Based Audit and Feedback Module

Joel C Boggan et al. J Grad Med Educ. 2014 Sep.

Abstract

Background: Systematically engaging residents in large programs in quality improvement (QI) is challenging.

Objective: To coordinate a shared QI project in a large residency program using an online tool.

Methods: A web-based QI tool guided residents through a 2-phase evaluation of performance of foot examinations in patients with diabetes. In phase 1, residents completed reviews of health records with online data entry. Residents were then presented with personal performance data relative to peers and were prompted to develop improvement plans. In phase 2, residents again reviewed personal performance. Rates of performance were compared at the program and clinic levels for each phase, with data presented for residents. Acceptability was measured by the number of residents completing each phase. Feasibility was measured by estimated faculty, programmer, and administrator time and costs.

Results: Seventy-nine of 86 eligible residents (92%) completed improvement plans and reviewed 1471 patients in phase 1, whereas 68 residents (79%) reviewed 1054 patient charts in phase 2. Rates of performance of examination increased significantly between phases (from 52% to 73% for complete examination, P < .001). Development of the tool required 130 hours of programmer time. Project analysis and management required 6 hours of administrator and faculty time monthly.

Conclusions: An online tool developed and implemented for program-wide QI initiatives successfully engaged residents to participate in QI activities. Residents using this tool demonstrated improvement in a selected quality target. This tool could be adapted by other graduate medical education programs or for faculty development.

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Figures

FIGURE
FIGURE
Sample Phase-1 Online Project Work Flow Box
See this image and copyright information in PMC

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