Quality improvement project (QUIP) concepts are becoming embedded into medical school curricula, with many students now expected to conduct a QUIP as part of their progression. This study aimed to assess whether student-led QUIPs can be effective and sustainable. A systematic literature search was conducted using 5 databases: MEDLINE, Embase, Ovid, CINAHL, and PsycINFO. The authors searched for articles published between January 28, 1978, and January 28, 2018. In all, 3965 articles were identified through database searching, and an additional 9 articles through hand searches. After screening and full-text analysis, 12 articles were included. Greater than 50% of QUIPs described a statistically significant improvement in the primary outcome. However, effective student-led QUIPs were not necessarily sustainable, with a mean final audit at 4.4 months. Medical students have the potential to produce effective QUIPs. There now needs to be a structured approach to give medical students the freedom to test and validate more unique interventions.
SaverBGMartinSAAdlerRNet al. Care that matters: quality measurement and health care. PLoS Med. 2015;12:e1001902.
2.
General Medical Council. The Good Medical Practice Framework for Appraisal and Revalidation. Manchester, UK: General Medical Council; 2013.
3.
SchoutenLMTHulscherMEJLvan EverdingenJJEHuijsmanRGrolRPTM. Evidence for the impact of quality improvement collaboratives: systematic review. BMJ. 2008;336:1491-1494.
4.
GeymanJ. Crisis in U.S. health care: corporate power still blocks reform. Int J Health Services. 2018;48:5-27.
5.
WellsSTamirOGrayJNaidooDBekhitMGoldmannD.Are quality improvement collaboratives effective? A systematic review. BMJ Qual Saf. 2018;27:226-240.
6.
NairPBaraiIPrasadSGadhviK.Quality improvement teaching at medical school: a student perspective. Adv Med Educ Pract. 2016;7:171-172.
7.
MoherDLiberatiATetzlaffJAltmanDG.Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med. 2009;151:264-269, w264.
8.
SchardtCAdamsMBOwensTKeitzSFonteloP.Utilization of the PICO framework to improve searching PubMed for clinical questions. BMC Med Inform Decis Mak. 2007;7:16.
OgrincGMooneySEEstradaCet al. The SQUIRE (Standards for QUality Improvement Reporting Excellence) guidelines for quality improvement reporting: explanation and elaboration. Qual Saf Health Care. 2008;17(suppl 1):i13-i32.
11.
HempelSShekellePGLiuJLet al. Development of the Quality Improvement Minimum Quality Criteria Set (QI-MQCS): a tool for critical appraisal of quality improvement intervention publications. BMJ Qual Saf. 2015;24:796-804.
12.
BoydSAggarwalIDaveyPLoganMNathwaniD.Peripheral intravenous catheters: the road to quality improvement and safer patient care. J Hosp Infect. 2011;77:37-41.
13.
SpenceJGoodwinBEnnsCDeanH.Student-observed surgical safety practices across an urban regional health authority. BMJ Qual Saf. 2011;20:580-586.
14.
LilicNJayanathaKStoneP.Routine postnatal use of the Kleihauer-Betke test for anti-D administration in rhesus D-incompatible pregnancies: a medical student quality improvement project. Jt Comm J Qual Patient Saf. 2013;39:324-327.
15.
DoersMEBeniwal-PatelPKuesterJFletcherKE.Feedback to achieve improved sign-out technique. Am J Med Qual. 2014;30:353-358.
16.
ChaudhrySRHanna-AttishaMLaChanceJReyesGAririguzoJFadlH.Primary resident physician: improving continuity of care. J Grad Med Educ. 2015;7:291-292.
17.
BockAChintamaneniKReinLFrazerTKayasthaGMacKinneyT.Improving pneumococcal vaccination rates of medical inpatients in urban Nepal using quality improvement measures. BMJ Qual Improv Rep. 2016;5(1). doi:10.1136/bmjquality.u212047.w4835
18.
KilduffCLoisC.Red eyes and red-flags: improving ophthalmic assessment and referral in primary care. BMJ Qual Improv Rep. 2016;5(1). doi:10.1136/bmjquality.u211608.w4680
19.
RadenkovicDKotechaSPatelSet al. Improving maternal confidence in neonatal care through a checklist intervention. BMJ Qual Improv Rep. 2016;5(1). doi:10.1136/bmjquality.u210655.w4292
20.
DroullardDPorterSZuckermanAMonieDBrendleJWeilH.Medical students leading quality improvement: a Lean Six Sigma approach to pain management. Am J Med Qual. 2017;32:569.
21.
FeldmanJDavieSKiranT.Measuring and improving cervical, breast, and colorectal cancer screening rates in a multi-site urban practice in Toronto, Canada. BMJ Qual Improv Rep. 2017;6(1). doi:10.1136/bmjquality.u213991.w5531
22.
LucasNCHumeCGAl-ChanatiAet al. Student-led intervention to inNOvate hand hygiene practice in Auckland Region’s medical students (the No HHARMS study). N Z Med J. 2017;130(1448):54-63.
23.
MabeyEIsmailSTailorF.Improving venous thromboembolism risk assessment rates in a tertiary urology department. BMJ Open Qual. 2017;6(2):e000171.
24.
SlackADDingwallMAStoneJCGainesMBadgettRG.The multiple benefits of inserting interdisciplinary quality improvement teams led by medical students into a faculty practice primary care clinic. Am J Med Qual. 2014;29:456.
25.
SaymaMHyneRSharmaMet al. From inpatient notes to outpatient follow-up: enhancing the rhinology service in a tertiary centre through student led projects. Int J Otolaryngol. 2015;2015:197823.
26.
MuslehMAshworthJBlackGHallG.Improving diagnosis for congenital cataract by introducing NGS genetic testing. BMJ Qual Improv Rep. 2016;5(1). doi:10.1136/bmjquality.u211094.w4602
27.
ThorntonLRahunathanNVermaNWongK.Improving referrals for tilt table testing in patients with transient loss of consciousness. BMJ Qual Improv Rep. 2016;5(1). doi:10.1136/bmjquality.u209365.w3837
28.
AbdollahiLTabriziJSJodatiASafaieNMoradi-JooMDaemiA.Quality of surgical scrub in a heart hospital: do not take it for granted. J Cardiovasc Thorac Res. 2017;9:164-169.
29.
BhattiAAshJGokaniSSinghS.Hydration stickers—improving oral hydration in vulnerable patients. BMJ Qual Improv Rep. 2017;6(1). doi:10.1136/bmjquality.u211657.w6106
30.
EllisRIzzuddin Mohamad NorAPimentilIBitewZMooreJ.Improving surgical and anaesthesia practice: review of the use of the WHO safe surgery checklist in Felege Hiwot Referral Hospital, Ethiopia. BMJ Qual Improv Rep. 2017;6(1). doi:10.1136/bmjquality.u207104.w6251
31.
MundellLLindemannRDouglasJ.Monitoring long-term oral corticosteroids. BMJ Open Qual. 2017;6:e000209.
32.
NattNKlarECheungIMatharuPBordmanR.Increasing organ donor registration in a primary care clinic. BMJ Qual Improv Rep. 2017;6(1). doi:10.1136/bmjquality.u222401.w8341
33.
ElnickiDMCooperA.Effects of varying inpatient attending physician rotation length on medical students’ and attending physicians’ perceptions of teaching quality. Teach Learn Med. 2011;23:37-41.
34.
EcclesMGrimshawJCampbellMRamsayC.Research designs for studies evaluating the effectiveness of change and improvement strategies. Qual Saf Health Care. 2003;12:47-52.
35.
SheridanNFKenealyTWConnollyMJet al. Health equity in the New Zealand health care system: a national survey. Int J Equity Health. 2011;10:45.
36.
Von FurstenbergDPrzekopERyanJM inventors; Cleveland Clinic Foundation, DianeVon Furstenberg Studio LP, assignee. Patient garment. US patent 20120151658A1. June21, 2012.
37.
LittlejohnsPKnightALittlejohnsAPooleTLKieslichK.Setting standards and monitoring quality in the NHS 1999-2013: a classic case of goal conflict. Int J Health Plann Manage. 2017;32:e185-e205.
38.
FlamingDBarrett-SmithLBrownNCorcoranJ. “Ethics? But it’s only quality improvement!” Healthc Q. 2009;12:50-55.
39.
JefferiesRSheriffIHMatthewsJHet al. Leadership and management in UK medical school curricula. J Health Organ Manag. 2016;30:1081-1104.
40.
TartagliaKMWalkerC.Effectiveness of a quality improvement curriculum for medical students. Med Educ Online. 2015;20:27133.
41.
WhittingtonJWNolanKLewisNTorresT.Pursuing the triple aim: the first 7 years. Milbank Q. 2015;93:263-300.
42.
WiseMKoolBSadlerLPeiris-JohnRRobbGWellsS.Teaching quality improvement to medical students: over a decade of experience. N Z Med J. 2017;130:45-52.
43.
BakerGRBarnsleyJMurrayM.Continuous quality improvement in Canadian health care organizations. Leadersh Health Serv. 1993;2(5):18-23.
44.
HassettMJ.Quality improvement in the era of big data. J Clin Oncol. 2017;35:3178-3180.
45.
BagenalJ.BMJ Open Quality launch. BMJ Open Qual. 2017;6:e000148.
