The Impact of a Preventive Cardiology Quality Improvement Intervention on Residents and Clinics: A Qualitative Exploration

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Abstract
Teaching and evaluating quality improvement (QI) is one corollary of new competency requirements in practice- and systems-based learning and improvement. This study explored the impact of the Preventive Cardiology Practice Improvement Module (PC- PIM) on residency clinics. Results from 22 clinic interviews indicated merit in using the PC-PIM to teach QI during residency. Many residents reported increased knowledge and confidence, particularly regarding the value of QI. The majority recognized that QI often leads to improved patient care and outcomes, even in resource poor environments. Conducting aspects of the QI process themselves (eg, chart audit, decision making) led to greater awareness of the patient and systems perspectives. Barriers included a lack of resident buy-in, discontinuity of care, and a lack of institutional support. These findings shed light on how residency clinics engage in QI activities and may aid in the implementation of future QI initiatives in residency more generally. (Am J Med Qual 2009;24: 99-107)