title: Integrating improvement competencies into residency education: a pilot project from a pediatric continuity clinic.
abstract: OBJECTIVE
  The Accreditation Council for Graduate Medical Education (ACGME) requires residents to attain 6 core competencies. This article describes a model for integrating 2 of these competencies (practice-based learning and improvement and systems-based practice) into residency education and assesses the clinical outcomes achieved for patients.
  
  
  METHODS
  An observational study with before-after comparisons.
  
  
  METHODS
  Pediatric faculty facilitated multidisciplinary improvement team meetings (which included 8 residents) and implemented an established improvement model to improve the selected clinical condition (immunizations).
  
  
  METHODS
  The proportion of consecutive children who were up-to-date on DTP, polio, MMR, HIB, and hepatitis B vaccines by 24 months of age.
  
  
  RESULTS
  The residents' improvement team successfully implemented 5 changes in the clinic process, which coincided with an increase in immunization rates for 2-year-olds during the 1-year study period. Clinic immunization rates increased from 60% at baseline to 86% at follow-up (P =.04).
  
  
  CONCLUSIONS
  This study suggests that it is feasible to integrate practice-based learning and improvement and systems-based practice into residency education while providing a valuable learning experience for residents and improving patient outcomes.
authors.affiliation: Department of Anesthesia and Critical Care, University of Chicago, Chicago, IL 60637, USA. jmohr@dacc.uchicago.edu
authors.forename: Julie J
authors.initials: JJ
authors.lastname: Mohr
authors.forename: Greg D
authors.initials: GD
authors.lastname: Randolph
authors.forename: Matthew M
authors.initials: MM
authors.lastname: Laughon
authors.forename: Eva
authors.initials: E
authors.lastname: Schaff
mesh_terms: D000068:Accreditation; D002675:Child, Preschool; D002983:Clinical Competence; D003162:Competency-Based Education; D003266:Continuity of Patient Care; D006801:Humans; D007114:Immunization / Q000706:statistics & numerical data*; D007396:Internship and Residency / Q000458:organization & administration*; D017145:Models, Educational; D009657:North Carolina; D010372:Pediatrics / Q000193:education* / Q000592:standards; D010817:Physician-Patient Relations; D010865:Pilot Projects; D015397:Program Evaluation; D012985:Software Design; D018511:Systems Integration; D017749:Total Quality Management