OP-192 : Teaching Family Medicine Residents About Quality Improvement Practices Utilizing a Chronic Kidney Disease Co-management Project Involving Family Physicians and Nephrologists

Jerry W. Sayre Mayo Clinic, Jacksonville, Florida, USA
Early identification and treatment of chronic kidney disease (CKD) allows for the provision of optimal patient care, slowing the risk of progression to advanced chronic kidney disease. Primary care physicians are the providers of the initial diagnosis, treatment, and referral, when necessary, for optimal patient care. Controversy and conflict occasionally exists among primary care physicians and nephrologists regarding the appropriate timing of these referrals. For example, recent clarification of CKD stages has not been uniformly accepted among all physicians. Another potential source of conflict has been gaps in the follow-up communication loops among the nephrologists, the referring physicians, and the patients. The Renal Physicians Association (RPA) has developed a validated communication toolkit to facilitate this process. Medical students are exposed to quality metric concepts but have had little experience in developing and using quality improvement practices in patient care settings. This project extends and uses the findings from a recent qualitative study of nephrologists and primary care physicians, involving the RPA CKD Toolkit, to introduce quality improvement practices to Family Medicine residents. A pre-intervention survey is administered to assess residents’ current knowledge of quality improvement processes. Family Medicine residents are given didactic instruction in quality improvement principles, followed by workshops involving experiential learning focused on identification and utilization of CKD toolkit items. Residents then utilized this knowledge in communication with selected nephrologists, evaluating the potential utilization of quality improvement communication practices. Residents demonstrated their understanding of the quality improvement principles in CKD by verbal presentations to peers and core faculty. This is proving to be a useful educational practice to train residents in both the methodological modalities of quality improvement and the usefulness of improved communication practices.
Keywords: quality, education, chronic kidney disease