Results of a Virtual Multi-Institutional Program for Quality Improvement Training and Project Facilitation

Monica Miranda-Schaeubinger; Kandice Garcia Tomkins; Ethan Larsen; Valerie Rigby; Ammie M White; Raymond W Sze; David B Larson

doi:10.1016/j.jacr.2022.08.014

Results of a Virtual Multi-Institutional Program for Quality Improvement Training and Project Facilitation

J Am Coll Radiol. 2023 Feb;20(2):173-182. doi: 10.1016/j.jacr.2022.08.014. Epub 2022 Oct 20.

Authors

Monica Miranda-Schaeubinger¹, Kandice Garcia Tomkins², Ethan Larsen³, Valerie Rigby⁴, Ammie M White⁵, Raymond W Sze⁶, David B Larson⁷

Affiliations

¹ Postdoctoral Fellow, Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania. Electronic address: https://twitter.com/MonicaMirandaSc.
² Quality Improvement Manager, Department of Radiology, Stanford University School of Medicine, Stanford, California.
³ Human Factors Engineer, Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania. Electronic address: https://twitter.com/EthanLarsen10.
⁴ Clinical Quality Manager, Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
⁵ Associate Chair, Patient Safety, Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; and University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania.
⁶ Associate Radiologist-in-Chief and the Kenneth E. Fellows Endowed Chair in Radiology Quality & Safety, Department of Radiology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
⁷ Senior Vice Chair, Strategy and Clinical Operations, Department of Radiology, Stanford University School of Medicine, Stanford, California; and Chair, Commission on Quality and Safety and Member, Board of Chancellors, American College of Radiology. Electronic address: david.larson@stanford.edu.

PMID: 36272524
DOI: 10.1016/j.jacr.2022.08.014

Abstract

Objective: The purpose of this project was to describe the results of a multi-institutional quality improvement (QI) program conducted in a virtual format.

Methods: Developed at Stanford in 2016, the Realizing Improvement Through Team Empowerment program uses a team-based, project-based improvement approach to QI. The program was planned to be replicated at two other institutions through respective on-site programs but was converted to a multi-institutional virtual format in 2020 in response to the COVID-19 pandemic. The virtual program began in July 2020 and ended in December 2020. The two institutions participated jointly in the cohort, with 10 2-hour training sessions every 2 weeks for a total of 18 weeks. Project progress was monitored using a predetermined project progress scale by the program manager, who provided more direct project support as needed.

Results: The cohort consisted of six teams (37 participants) from two institutions. Each team completed a QI project in subjects including MRI, ultrasound, CT, diagnostic radiography, and ACR certification. All projects reached levels of between 3.0 (initial test cycles begun with evidence of modest improvement) and 4.0 (performance data meeting goal and statistical process control criteria for improvement) and met graduation criteria for program completion.

Discussion: We found the structured problem-solving method, along with timely focused QI education materials via a virtual platform, to be effective in simultaneously facilitating improvement projects from multiple institutions. The combination of two institutions fostered encouragement and shared learning across institutions.

Keywords: Education; quality improvement; training; virtual education.

MeSH terms

COVID-19*
Clinical Competence
Humans
Internship and Residency*
Pandemics
Quality Improvement