Aims Paediatric postgraduate training needs to prepare paediatricians for the future delivery of high quality care. Doctors in Postgraduate Training (DrPGT) are often best placed to identify safety/quality concerns and can innovate across organisational boundaries. To address this, a programme was developed at a large tertiary centre providing a supportive educational environment. Its aims are to allow experiential learning on an improvement project alongside teaching of quality improvement (QI) and systems theory.
Methods EQuIP (Enabling Doctors in Quality Improvement and Patient Safety) supports DrPGTs through a QI project within their department, aligned to Trust’s objectives. A three level approach to the programme ensures DrPGT engagement. All DrPGTs participate in a 1hr workshop to understand the importance of QI (level 1). Level 2 is a 6-month rotational programme with 2 full day workshops on improvement methodology, project surgeries facilitated by managers, and mentoring with senior clinicians. Level 3 is more intensive, over a 9 month period, to develop expertise and deliver level 1 workshops. The innovation involves a peer-designed programme while being work-based, delivering organisational strategies. Pre- and post- programme questionnaires allow Kirkpatrick 4-level evaluation.
Results All 40 participants agreed that the project was a valuable learning experience and that the programme met their expectations (level 1, reaction). Level 2, learning, was demonstrated by an improvement in QI definitions post programme, awareness of QI resources and confidence in using methodologies including PDSA and process mapping (P < 0.001). Post programme, all but one participant said they are planning another QI project and that they are more aware of improvement work in their unit (behaviour change, level 3). Benefits to the organisation (level 4) are evident from successful projects presented to the executive team showing reduction in DNA rates, improved theatre efficiency, improved quality of medical notes etc.
Conclusion EQuIP changes the way DrPGTs view healthcare as they become quality champions for their department. The design and evaluation of EQuIP may inform similar educational programmes in other organisations. This capacity building is crucial to ensure future Paediatric leaders have the skills and motivation to improve the effectiveness of our healthcare system.