"It Feels Like a Lot of Extra Work": Resident Attitudes About Quality Improvement and Implications for an Effective Learning Health Care System.

摘要: The learning health care system promotes development and application of evidence generated within the to enhance quality patient care. purpose this study was understand resident attitudes about improvement (QI) in Accreditation Council for Graduate Medical Education–approved programs. Four focus groups were conducted with 45 residents at University Utah School Medicine during September October 2014. Residents discussed perceived value QI their experiences QI. Qualitative analysis iteratively, resulting a set constructs that then consolidated into overarching themes. Five themes emerged from qualitative analysis. Four these represented participation barriers: challenges understanding vision QI, confusion basic aspects sense contributions are not valued/valuable process, prioritizing responsibilities relating compared other responsibilities. One theme facilitator successful QI: factors make work successfully (e.g., clear goals being on “same page”). If do improve, culture is threatened. An important step enhancing resolving tension between providing excellent satisfying goals. Involving more effectively may result improved promote better-functioning system.