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    Quality improvement: Why residents should get involved

    Nirmish Singla, MD

    Urology Times Blogger Profile

    Dr. Singla is a urology resident at the University of Texas Southwestern, Dallas

    During residency, the challenge of studying urology, becoming an accomplished clinician and skilled surgeon, staying abreast of the latest research, and maintaining academic productivity is daunting enough. To top off these expectations, the Accreditation Council for Graduate Medical Education (ACGME) further mandates that all residents “actively participate in interdisciplinary clinical quality improvement and patient safety programs.”

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    While this quality improvement (QI) requirement is viewed by many as simply another checkbox to mark off, it is worthwhile to take a moment to appreciate the underlying rationale behind it and the hidden gains QI involvement can offer.

    QI can be defined or interpreted in multiple ways, and there are several avenues by which one can become involved. The underlying principle of QI is the expectation—both from patients and the hospital system—that physicians provide safe, cost-effective, and high-quality health care. QI initiatives can range anywhere from simple, commonly encountered grassroots issues to more complex, systems-wide implementation of changes.

    Involvement in QI is by no means restricted to hospital administrators. One way to go about tackling a QI project is to begin by identifying a problem or frustration faced daily in clinical practice, if even seemingly minor in nature. Some varied examples may include infectious or hemorrhagic complications following outpatient urologic procedures such as prostate biopsies; Clostridium difficile infections, thromboembolic events, or patient falls following urologic surgery; delayed starts to first operative cases of the day; delayed turnover between patients in the clinic or OR setting; unnecessary prolongation of hospital length of stay due to non-medical factors such as those that are socially or consultation-related; unnecessary patient calls or presentation to the emergency room following ureteral stent placement due to pain or hematuria; or inappropriate implementation of contact precautions.

    Next: Improving QI

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