Using quality improvement tools to enhance workplace learning in an anaesthesia unit

Abstract

Background

In healthcare, quality improvement (QI) tools are predominantly used to address human, system and process factors to improve clinical care. We believe that QI tools can also be used to address similar factors in medical education, to facilitate improvement in learning outcomes and competencies for new junior doctors in a postgraduate medical education program in our anaesthesia and critical care unit.

Methods

A stepwise competency checklist was devised to guide the learning and monitor the percentage who had completed the required learning activities and tests at the end of each month. This was tabulated as monthly competency scores, and served as a measure of effectiveness of the education program. QI tools, namely the Fishbone diagram and Pareto chart, were used to identify modifiable root causes and prioritise interventions.

Results

Monthly competency scores ranged 30–50% at baseline, and improved to 60–75% after 6 months, with the implementation of a series of QI interventions.

Conclusion

QI tools were utilised to guide education interventions, with consequent improvement in the monthly competency scores of our junior doctors. Focused improvement cycles that are aligned to learning outcomes are key to the success of using QI tools in medical education.

Keywords:

• Work-based
• postgraduate
• medical education research
• anaesthetics

Acknowledgments

The authors would like to thank the Medical Affairs (Clinical Governance) Team of the National University Hospital Singapore who supported the Quality Improvement Project.

Disclosure statement

The authors report no conflict of interest. The authors alone are responsible for the content and the writing of this article.

Glossary

Workplace Learning: The acquisition of knowledge or skills by formal or informal means that occurs in the workplace.

Cacciattolo K. 2015. Defining workplace learning. European Scientific Journal. 11(10).

Additional information

Notes on contributors

Theng Wai Foong

Theng Wai Foong, MBBS, M.Med (Anaesth), is a consultant and a member of the education core team at the department of anaesthesia and surgical intensive care, National University Hospital, Singapore. She is also a clinical lecturer at the Yong Loo Lin School of Medicine, National University of Singapore.

Hui-Fen Tiong

Hui-Fen Tiong, MBBS, M.Med (Anaesth), is a senior resident and a member of the education core team at the department of anaesthesia and surgical intensive care, National University Hospital, Singapore.

Say Yang Ong

Say Yang Ong, MBBS, M.Med (Anaesth), FANZCA, FAMS, is a consultant at the department of anaesthesia and surgical intensive care, National University Hospital, Singapore.

Fun Gee Chen

Fun Gee Chen, MBBS, M.Med (Anaesth), FFARACS, FANZCA, FAMS, is the director of the division of critical care and senior consultant at the department of anaesthesia and surgical intensive care, National University Hospital, Singapore. He is also the director of the division of graduate medical studies at the Yong Loo Lin School of Medicine, National University of Singapore.