Oct 1, 2020
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Hello! MS1 here really interested in QI research. Would anyone be able to provide further insight in general on what types of QI projects are publication worthy (eg chart reviews, surveys/ procedural interventions, etc.)? Does it make a difference if it is at a community hospital vs large academic hospital? One of my goals is to have a publishable QI project from beginning to end so I'm just trying to figure out the best way to go about finding this. Any tips would be greatly appreciated!

edit: also wondering if someone can comment on where QI research ranks in terms of adding "value" compared to clinical research or public health research :)
 
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Dral

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Getting something published is noteworthy and important in itself regardless of the topic and where the research is being done.

I think it's easier to churn out chart review papers.
I can't say I disagree with this statement, but I will clarify with this:

As someone who reviews apps for residents and fellows, I would rather see one solid research paper with original durable data that a student spearheaded opposed to 5 case reports or even a review.

Quality over quantity in general.


The impact of the project will determine if it is publishable or not. I am the current faculty mentor on the QI project for our fellows and I think it will be publishable. It is something that other places would want to know about, but I would guess it wouldn't be much more than a 'letter' type publication. If we had more than a year to work on it, I think we could surely flesh it out to a solid manuscript though.

If you want a full blown project/manuscript, you'll likely need to latch on to a mentor who is connected.

A lot of QI projects involve surveys. There is a lot to survey theory (it's not just throwing questions on survey monkey). Not all need surveys, but it a good way to show before and after changes (through workplace satisfaction, process improvement, etc).

The best QI projects improve a real life problem that providers (or others) have often. So it may help to talk to a few providers in your field of interest to learn about some things that can be improved upon. An example would be in surgery, patients calling back after surgery with wound infection concerns. The intervention would be creating a brochure with pictures of healing wounds and sending it home with pts on d/c. You would take metrics on number of calls about wounds before and after the intervention (that one wouldn't really involve a survey probably). That is an example of something that you could probably publish if you could get enough data. It improves quality (giving pts better health information), cost (less time spent by providers addressing those concerns and being more productive), and even access a little bit (not having to call for a concern in the first place) (the three main big picture metrics of healthcare).

I don't think it matters if it's community or academic.

I would still hold a solid bench research paper of similar quality above a QI project personally, but I would certainly be impressed with a 1st/2nd year med student who spearheaded a good QI project that was published.

Disclaimer: The following is totally my personal opinion

Bench > Clinical (clinical trial > cohort > case control) > QI > Meta analysis > review (chart > lit) > observation study > case series with review > case report

A start to finish solid translational project to me is the ultimate, though.
 
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IMGASMD

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I can't say I disagree with this statement, but I will clarify with this:

As someone who reviews apps for residents and fellows, I would rather see one solid research paper with original durable data that a student spearheaded opposed to 5 case reports or even a review.

Quality over quantity in general.


The impact of the project will determine if it is publishable or not. I am the current faculty mentor on the QI project for our fellows and I think it will be publishable. It is something that other places would want to know about, but I would guess it wouldn't be much more than a 'letter' type publication. If we had more than a year to work on it, I think we could surely flesh it out to a solid manuscript though.

If you want a full blown project/manuscript, you'll likely need to latch on to a mentor who is connected.

A lot of QI projects involve surveys. There is a lot to survey theory (it's not just throwing questions on survey monkey). Not all need surveys, but it a good way to show before and after changes (through workplace satisfaction, process improvement, etc).

The best QI projects improve a real life problem that providers (or others) have often. So it may help to talk to a few providers in your field of interest to learn about some things that can be improved upon. An example would be in surgery, patients calling back after surgery with wound infection concerns. The intervention would be creating a brochure with pictures of healing wounds and sending it home with pts on d/c. You would take metrics on number of calls about wounds before and after the intervention (that one wouldn't really involve a survey probably). That is an example of something that you could probably publish if you could get enough data. It improves quality (giving pts better health information), cost (less time spent by providers addressing those concerns and being more productive), and even access a little bit (not having to call for a concern in the first place) (the three main big picture metrics of healthcare).

I don't think it matters if it's community or academic.

I would still hold a solid bench research paper of similar quality above a QI project personally, but I would certainly be impressed with a 1st/2nd year med student who spearheaded a good QI project that was published.

Disclaimer: The following is totally my personal opinion

Bench > Clinical (clinical trial > cohort > case control) > QI > Meta analysis > review (chart > lit) > observation study > case series with review > case report

Bench is your #1?!
 
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Oct 1, 2020
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I can't say I disagree with this statement, but I will clarify with this:

As someone who reviews apps for residents and fellows, I would rather see one solid research paper with original durable data that a student spearheaded opposed to 5 case reports or even a review.

Quality over quantity in general.


The impact of the project will determine if it is publishable or not. I am the current faculty mentor on the QI project for our fellows and I think it will be publishable. It is something that other places would want to know about, but I would guess it wouldn't be much more than a 'letter' type publication. If we had more than a year to work on it, I think we could surely flesh it out to a solid manuscript though.

If you want a full blown project/manuscript, you'll likely need to latch on to a mentor who is connected.

A lot of QI projects involve surveys. There is a lot to survey theory (it's not just throwing questions on survey monkey). Not all need surveys, but it a good way to show before and after changes (through workplace satisfaction, process improvement, etc).

The best QI projects improve a real life problem that providers (or others) have often. So it may help to talk to a few providers in your field of interest to learn about some things that can be improved upon. An example would be in surgery, patients calling back after surgery with wound infection concerns. The intervention would be creating a brochure with pictures of healing wounds and sending it home with pts on d/c. You would take metrics on number of calls about wounds before and after the intervention (that one wouldn't really involve a survey probably). That is an example of something that you could probably publish if you could get enough data. It improves quality (giving pts better health information), cost (less time spent by providers addressing those concerns and being more productive), and even access a little bit (not having to call for a concern in the first place) (the three main big picture metrics of healthcare).

I don't think it matters if it's community or academic.

I would still hold a solid bench research paper of similar quality above a QI project personally, but I would certainly be impressed with a 1st/2nd year med student who spearheaded a good QI project that was published.

Disclaimer: The following is totally my personal opinion

Bench > Clinical (clinical trial > cohort > case control) > QI > Meta analysis > review (chart > lit) > observation study > case series with review > case report
Thank you everyone so much! I really appreciate everyone’s comments. As far as doing a full blown project/ manuscript and getting a solid mentor, would this be someone in the QI department or a physician in the field you’re interested in doing research for?

I often hear advice of doing data mining or chart reviews and just getting the # of publications as high as possible, but now that you mention quality over quantity I think it does make sense to maybe take advantage of that time since I’m a first year student to spearhead something meaningful. Maybe some of that advice of "just try to tack your name on anything" approach would be more relevant in MS3?
 

Dral

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It’s never more relevant in my book. I’m in a competitive field and it’s obvious when someone just went though the motions and did 6 case reports and a review. Don’t get me wrong, it’s totally ok to do that. However, that is almost the baseline.

It’s understood that just getting your name on things is just what people sometimes end up doing. People have to start somewhere. Again, that’s fine, but it doesn’t stand out to me as much.

If a student comes up with a bench project, figured out and constructed some new molecular vector, used it to figure out a new disease process or treatment and then published it? That’s super impressive to me.

Take my advice with a grain of salt. It could be different for different fields (or individuals).

I’d say the best approach would be to go to a physician in the field you are interested in. There may be some QI project going on that you could latch on to. However, I’m sure it would be more fulfilling if you could just get some ideas and then come up with something on your own. I’m not sure if it’s like this for every field, but a QI project is part of my MOC cycle. I doubt you would have too much trouble finding something since the concept has really gotten fairly big recently.
 
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Dr G Oogle

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QI projects can be very impactful and result in high impact publications. An RCT looking at a better way to control postoperative pain is arguably a quality improvement, same as looking into how to minimize postoperative retention in spine patients or evaluating cost and utility of preoperative testing. I’m not sure how you’re defining QI though.
 
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mvenus929

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Thank you everyone so much! I really appreciate everyone’s comments. As far as doing a full blown project/ manuscript and getting a solid mentor, would this be someone in the QI department or a physician in the field you’re interested in doing research for?

Personally, I would recommend reaching out to both. Getting a QI manuscript published requires certain criteria, and it may be easier for you to have the whole project set up in that methodology from the beginning rather than realizing halfway through that you should've been looking at some other outcome (though that may still happen). For this reason, having someone familiar with QI methodology (in the QI department) will be enormously helpful. But, they can be divorced from the realities of the clinical setting as well, and not understand how processes work. If you're just a student and not continuously working in a division, then you may not understand processes well either, so having a faculty within your division of interest to serve as the clinical mentor will also be useful.
 
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Opomfrog

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QI research is good because its one way to get around the dreaded IRB. have you submitted one?
 
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It’s never more relevant in my book. I’m in a competitive field and it’s obvious when someone just went though the motions and did 6 case reports and a review. Don’t get me wrong, it’s totally ok to do that. However, that is almost the baseline.

It’s understood that just getting your name on things is just what people sometimes end up doing. People have to start somewhere. Again, that’s fine, but it doesn’t stand out to me as much.

If a student comes up with a bench project, figured out and constructed some new molecular vector, used it to figure out a new disease process or treatment and then published it? That’s super impressive to me.

Take my advice with a grain of salt. It could be different for different fields (or individuals).

I’d say the best approach would be to go to a physician in the field you are interested in. There may be some QI project going on that you could latch on to. However, I’m sure it would be more fulfilling if you could just get some ideas and then come up with something on your own. I’m not sure if it’s like this for every field, but a QI project is part of my MOC cycle. I doubt you would have too much trouble finding something since the concept has really gotten fairly big recently.
by review do you mean systematic review or lit review?
 

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