Quality Improvement and Patient Safety Curriculum

Quality Improvement & Patient Safety (QIPS) Experience

Quality Improvement and Patient Safety are an integral part of the University of Central Florida Internal Medicine Residency experience. We strive to cultivate a culture of systems thinking and where physicians can deliver safe, effective, patient centered, timely, efficient, and equitable care, as identified by the Institute of Medicine’s six aims for quality healthcare. We hope to develop physicians who embrace this culture and have the tools and knowledge to be able to carry these principles forward in their career.

The QIPS curriculum is a longitudinal curriculum extending from intern year through PGY3 year with an equal emphasis on inpatient and ambulatory experiences. Through formal didactic sessions, team activities, and a mentored performance improvement project, residents develop proficiency in the basics of QI and PS methodology. Residents work in teams to carry forward a QI project starting in the inpatient wards or outpatient clinics where they practice.

The curriculum culminates in the Annual Quality and Patient Safety Forum where all projects are presented. Many residents then choose to submit their projects to national conferences.

Topics covered in the formal didactic curriculum include:

• Introduction to the QI Movement
• History of QI in Healthcare
• Distinguishing QI from Research and Quality Assurance
• Publicly Reported Quality Metrics
• Principles of Patient Safety
• Error Reporting
• Starting a QI Project: Defining a Problem and Organizing a Team
• Creating a Problem Statement or an AIMS Statement
• Stakeholder Analysis
• Assessing Current Condition
• Root Cause Analysis
• Measuring for Improvement and Data Analysis
• Developing Countermeasures
• Pilot and Implementation Planning
• Change Management
• High Value Care

Additional opportunities include working on organizational QI efforts and performance improvement projects and Root Cause Analysis investigations.

In the 2023-2024 academic year, the program has two designated VA Chief Residents for Quality and Patient Safety. They are responsible for curriculum administration, resident QI project development and oversight, and serving as additional resources for the residents.

Our Quality Improvement and Patient Safety Team

Resident Projects

2022-2023

• Preventing Complications of High Dose Steroids for Patients at the Orlando VA Healthcare System
• Improving communication between nurses and residents at HCA Florida Osceola Hospital
• Improving the Blood Product Administration Process at HCA Florida Osceola Hospital
• Reducing Inappropriate NPO Orders for Scheduled TTE
• To Echo or not to Echo: Decreasing Overuse of Echocardiography in the Evaluation of Syncope at the Orlando VA Medical Center

2021-2022

• Eliminating Repetitive CBC Orders on the Resident Inpatient Service at the Orlando VAHCS
• Increasing the Rate of Pneumococcal Vaccination in Patients over 65 at HCA Florida Osceola Primary Care Clinic
• Improving Use of a Standardized Medical ICU Order Set
• Increasing Utilization of the FIB-4 Score to Improve Appropriate NAFLD Consultation to the Orlando VA GI/Hepatology Service
• Perfecting the Art of Consultation

2020-2021

• Patient Awareness of their Primary Providers During Admission
• Increasing Early Discharges among Residents on The Medicine Service
• Optimizing Oxygen Therapy: Is More Better?
• Increase Appropriate Code Status Documentation Among Patients at The Orlando VA Medical Center
• Increasing GOC Discussions and Life Sustaining Treatment Notes Among Veteran Patients 

2019-2020

• Don’t Wait, Deescalate: Improving De-escalation of Broad-Spectrum Antibiotics on the Inpatient Units at the Orlando VA with Positive FilmArray Blood Culture Identification Panel (BioFire)
• Optimizing the Use of Anti hypertensive Agents for Medicine Inpatients at Osceola Regional Medical Center
• Hypoglycemia and Sliding Scale Insulin,  A Quality Improvement Project
• Improving End-of-Life Care by Incorporating Goals of Care Discussions in the VA Outpatient Clinic
• Appropriate Use of VTE Prophylaxis in the Inpatient Setting

2018-2019

• SIGN OUT: Standardized Inpatient GME Night Float Organized Quality Transfer Of Patients
• Overuse of Supplemental Oxygen for Patients who are admitted to the Hospital
• Optimizing the Use of Statins for Primary Prevention in Diabetic Patients in the Resident Ambulatory Care Clinics
• To Trop or Not to Trop: Reducing Inappropriate Use of Troponins at the Orlando VA Medical Center
• Implementation of Routine Inpatient HIV Screening for Early Detection and Treatment of HIV

2017 – 2018

• Optimizing the Use of Prophylactic Bowel Regimen on Inpatients on Opiates at the Orlando VA Medical Center
• Hit it Right: Improving the Appropriateness of HIT Testing of Medicine Inpatients at the Orlando VAMC
• Over utilization of Telemetry use in Non-critically ill medical patients admitted to Osceola Regional Medical Center
•  Reducing the Unnecessary Use of Foley Catheters at the ORMC Resident Medicine Ward Services
•  More Drug, More Problems: Improving Polypharmacy for the Geriatric Population at the Orlando VAMC Resident Continuity Clinic

2016-2017

• Obtaining Cultures Before Antibiotic Administration at the Orlando VAMC
• STOP-BANG Screening of Sleep Apnea in the Resident Ambulatory Care Clinic at the Orlando VAMC
• Reducing Unnecessary Lab Draws at Osceola Regional Medical Center
• Improvement of Transition of Care from ICU to Primary Team at Osceola Regional Medical Center
• PADUA score for the Assessment of Prophylactic Anti coagulation for Medicine Inpatients at the Orlando VAMC