Poster, Podium & Video Sessions
Presentation Authors: Eugene Cone*, Durham, NC, Jonathan Bergman, Tannaz Moin, Los Angeles, CA, Ashley Wietsma, Durham, NC, Arlene Fink, Los Angeles, CA, B Price Kerfoot, Boston, MA, Charles Scales, Durham, NC
Introduction: The healthcare system increasingly links patient safety and explicit quality measures to health outcomes. In addition, under the aegis of the ACGME&[prime]s Next Accreditation System, urology residents must now receive training regarding quality improvement (QI). Competing demands of clinical care, other curricular topics, and lack of resources and faculty expertise pose challenges to QI educational programs. To develop content for a QI curriculum for urology residents, we identified 25 candidate topics. Our objective was to identify appropriateness of the topics using an expert panel.
Methods: We used a modified Delphi approach to gather consensus among a panel of QI and urology education experts through a novel online interface (ExpertLens). We asked experts to anonymously rate 25 topics across 3 domains: importance, feasibility, and potential impact on patient care if residents received instruction on the topic. Potential ratings ranged from 1 to 9 (1 = of no importance; 9 = extremely important). In Round 1, panelists rated each topic. In Round 2, panelists viewed aggregate ratings and justified their own choices through an online discussion board. In Round 3, panelists provided their final ratings based on the online discussion. Twenty-four experts were initially recruited, and 16 ultimately participated in all three rounds.
Results: Minimization of healthcare waste, use of high value care, and standardization of clinical processes scored the highest on importance and impact, while panelists felt that quality measurement tools (i.e., patient satisfaction measures, Physician Quality Reporting System) were less important to teach and unlikely to substantially improve patient care. Expert panelists clearly distinguish quality measurement (i.e. reporting systems) and quality improvement activities (Table).
Conclusions: These results broadly support a QI curriculum focused on methods to eliminate waste, standardize care pathways, and strengthen processes of urologic patient care. Educating residents about quality measurement and reporting may not meaningfully improve patient outcomes. Future research will assess methods to improve resident engagement in QI education.
Source Of Funding: Grant from the Society of Urologic Program Directors
Tuesday, May 16
7:00 AM – 9:00 AM