Easy QI projects

[spaceydaisy]

As a residency requirement, I have to do a QI project. Boo. We have Epic in a large hospital system and I really want to do a simple, easy project. I haven't been able to come up with anything good. Anyone have good QI projects they did in residency that worked out well I might be able to replicate or other ideas?

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[Stagg737]

Not my project, but a co-resident did one on outcomes of patients on a benzo-sparing taper since our hospital rolled that out as an order set earlier this year. Just have to do chart review and look at CIWA/AWAS scores and any major events.

 

[spaceydaisy]

Not my project, but a co-resident did one on outcomes of patients on a benzo-sparing taper since our hospital rolled that out as an order set earlier this year. Just have to do chart review and look at CIWA/AWAS scores and any major events.

That's a good one but we've had our CIWA protocol for a long time I think.

 

[clausewitz2]

That's a good one but we've had our CIWA protocol for a long time I think.

So the point of QI is to make incremental changes to existing policies and procedures to improve systemic functioning and outcomes. Long-standing protocols that are "just the way we do things around here" are perfect targets for QI.

 

[Stagg737]

That's a good one but we've had our CIWA protocol for a long time I think.

And if it's a benzo-based protocol then a good project could be implementing a benzo-sparing option and comparing outcomes like length of taper, doses/dosages required, CIWA scores, etc.

 

[Armadillos]

If this is just a graduation hoop to jump through keep it very simple.

Something like review small number charts from a resident clinic. See what percent recorded smoking status and offer cessation tx. Then give the residents a 10 minute lecture or change the note template or something. Then review some charts and see if it helped.

Can do similar for recording AIMS, SGA metabolic labs,etc.

 

[Stagg737]

If this is just a graduation hoop to jump through keep it very simple.

Something like review small number charts from a resident clinic. See what percent recorded smoking status and offer cessation tx. Then give the residents a 10 minute lecture or change the note template or something. Then review some charts and see if it helped.

Can do similar for recording AIMS, SGA metabolic labs,etc.

Coming up with templates and dot phrases is something that a lot of residents at my program do for our required QI project. Make it, present it to your program, and have them implement it. Pretty easy but really useful if they're good.

 

[NickNaylor]

Last year, me and a couple of my colleagues did a project looking at how frequently lab-based monitoring for patients on chronic antipsychotics were being followed. We did pre- and post-intervention chart review. Our "intervention" was essentially creating dot phrases that pull the most recent labs for whatever is indicated - for example, lipid panel and hemoglobin A1c for antipsychotics - which we then shared with residents rotating in the outpatient clinic. The only challenging thing about the study was doing a chart review as we were unable to get our IT staff to help us with pulling data from the EMR via reports. If this process is easier for you at your hospital, this would be a pretty simple project as the intervention is straightforward and the data analysis is similarly pretty basic.