Quality Improvement Program

Quality Improvement Program


QA/QI Program

Quality Assurance/Quality Improvement projects are initiatives that focus on one or more clinical or non-clinical area(s), with the aim of improving patient health outcomes and satisfaction. The NJMS Internal Medicine Residency Program provides a robust and structured QA/QI experience for all trainees that allows residents to actively participate in improving the care provided to our patients.

IHINew residents complete the Institute for Healthcare Improvement's Open School basic course in the start of their PGY-1 year. This online educational curriculum provides the appropriate framework for residents to participate in QA/QI projects. Our program spans all three training sites in both inpatient and outpatient settings. The structure allows residents to assess their practice for quality indicators, to formulate an improvement plan, and to follow-up on outcomes, all with progressive growth of responsibility and leadership through their training.

Each resident QA/QI team interfaces with faculty mentors and a designated Chief Resident for QA/QI every two months during ambulatory blocks. Teams are provided with feedback and direction, and progress goals for each meeting are clearly outlined at the start of the academic year:

  • Meeting 1: Literature search, formulate QA/QI question, complete CITI training
  • Meeting 2: Complete the protocol, submit IRB
  • Meeting 3: Data collection, preliminary analysis
  • Meeting 4: Data review and statistical analysis
  • Meeting 5: Abstract/poster ready for review, Encouraged to publish results, especially in the Rutgers Medical Journal QA/QI

Since launching in 2012, the program has resulted in statistically significant improvements in patient care in a number of different areas. For example, AAA screening increased by 40% in the outpatient resident clinic, smoking cessation counseling increased by 30%, vaccination rates have risen dramatically, and Hypertension and Diabetes control and monitoring have improved substantially. In 2022, our residents published an article in BMJ Open Quality, showing that a simple EMR-based intervention increased appropriate statin prescribing by almost 10%! Many, many other projects have been published or presented at national and regional conferences, including several award-winning posters and oral presentations.

In 2023, the program will be launching further improvements to this program, the highlights of which will include:

  • QA/QI and Patient Safety education workshops built into the curriculum, every 2 months during “Ambulatory Academic Half Days”
  • Formation of a QA/QI Patient Safety Council, that includes representation from faculty, residents, and clinic administration and staff
  • Structured mentorship, incorporating faculty across all 3 sites


A sample of recently completed QA/QI projects in 2022 include:

  • PrEP prescribing
  • Hepatitis B vaccination
  • Pneumococcal vaccination
  • Adherence to USPSTF guidelines for lung cancer screening
  • AHA/ACC guideline adherence for treatment resistant hypertension
  • OSA Screening
  • Identification and treatment of Latent TB
  • Depression screening
  • Iron deficiency anemia detection and management
  • MELD score utilization in cirrhotic patients
  • Pulmonary Function Test utilization
  • Adherence to asthma guidelines
  • Colorectal cancer screening
  • Hyperkalemia management
  • COVID vaccination in high-risk veterans
  • Assessing patient flow through the clinics