Skip to Main Content
Skip Nav Destination

The Driver for Doing Quality Improvement in the Clinical Setting: Is it a Carrot or a Stick? :

October 10, 2018

Central to improving the value of the health care we deliver is to ensure that it is high quality.

Central to improving the value of the health care we deliver is to ensure that it is high quality. Yet despite the many reasons that have moved quality improvement (QI) into the spotlight in this country and around the world, just how many of us have incorporated a quality improvement project or projects into our practices? For those who are doing this, is it because what you are doing represents a meaningful way to improve what you do or is QI being done more to meet a requirement for Maintenance of Certification (MOC)?  To answer this question, Freed et al. (10.1542/peds.2018-0712) surveyed pediatricians enrolled in the American Board of Pediatrics Maintenance of Certification program in 2016, with a good response rate of over 70% (8700 diplomates).  If you want to look at the results with the cup half full, 86.6% of respondents said they were engaged in at least one QI activity in the prior year, ranging from 79.9% for non-academic practitioners to 94.2% for academic specialists. If you want to look at the results with the cup half empty, one in five practicing pediatricians and one in ten specialisst are not participating in a QI activity, and for those who are, the main driver for at least half is to maintain board certification via MOC with the desire to improve the quality of the practice through change in a process or to work collaboratively with others being less important.

So what does this study tell us?  We invited Cincinnati hospitalists Drs. Trisha Marshall, Karen Jerardi, and Samir Shah (10.1542/peds.2018-2559) to weigh in with an accompanying commentary.  The authors of the commentary note the limitations of this survey study, and most importantly note the importance of all of us learning more about quality improvement science so that QI becomes an intrinsic driver and motivator of how we do our work, rather than just an extrinsic factor that threatens our certification if we don’t do a QI project.  They note that the need to do an ABP QI web-based improvement module in the absence of a meaningful project in the practice setting is not the solution to instilling the importance of quality improvement to enhance care delivery.  There is a lot to learn and to improve on after reading this study and commentary—and hopefully you will link to both and then share your thoughts on what meaningful QI you are or could be doing via a response to this blog, a comment on the study or commentary on our website or a posting on our Facebook or Twitter pages.

Close Modal

or Create an Account

Close Modal
Close Modal