542 - Improving Orientation and Education Experience for Pediatric Residents at a Level IV Neonatal Intensive Care Unit (NICU) Using QI Methodology & Engaging Infographics.
Sunday, April 30, 2023
3:30 PM – 6:00 PM ET
Poster Number: 542 Publication Number: 542.324
Noor Mehandi, Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo, Buffalo, NY, United States; Benjamin Balderman, Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo, Buffalo, NY, United States; Christina Sebastian, Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo, Buffalo, NY, United States; Sasha Amiri, Rush University Medical Center, Chicago, IL, United States; Gretell Gomez, University of Miami Leonard M. Miller School of Medicine, Miami, FL, United States; Laura Sandin, John R. Oishei Children's Hospital, Arcade, NY, United States; Katherine D. Perry, Kaleida Health, Getzville, NY, United States; Deepali Handa, Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo, Buffalo, NY, United States
Resident Physician Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo Buffalo, New York, United States
Background: Rotating through the Level IV NICU during pediatric residency can be challenging. Barriers to a rewarding NICU experience include lack of critical care experience, high acuity, large patient volume & lack of familiarity with NICU-specific EMR in our hospital. Additionally, duty hour restrictions, reduced NICU rotations & presence of Advanced Practice Providers (APP) have decreased resident exposure to the NICU. The dissatisfaction with orientation & education among the residents was highlighted in 2020, which led to this project. Objective: To improve pediatric resident satisfaction ratings for NICU orientation & education by a median of >1 point on a 5-point Likert scale by December 2022. Design/Methods: A multi-disciplinary QI team with the NICU medical director, chief resident, pediatric residents & APP leads was created in October 2020. An anonymous 10-question 5-point Likert-scale pre-survey on satisfaction with NICU orientation & education was sent to pediatric residents in Feb 2021. Multiple team discussions led to the creation of a key driver diagram for orientation & education (Fig 1). A formal orientation with standardized infographics, key points & engaging short PowToon videos was implemented. Educational goals for each rotation were devised based on American Board of Pediatrics topics & highlighted (Fig 2). An initial post-intervention survey sent in Oct 2021 showed improved satisfaction with orientation, while satisfaction with education lagged. A 2nd PDSA cycle was started in July 2022 to improve the education experience. It included dedicated twice-a-week sit-down teaching time by Neonatologists at 2pm & bi-annual dedicated NRP-based Sim sessions. 2nd survey was sent in Nov 2022. Data Analysis was completed using Wilcoxon signed-rank test. Results: 34 pediatric residents completed the pre-survey. 25 completed the post-intervention survey for education & 9 for orientation. The median values of the responses were plotted on the Likert scale and showed improvement by >1 point in all question categories. Data analyzed with Wilcoxon signed-rank test showed statistically significant improvement (p-value < 0.05) in all aspects (Fig 3).
Conclusion(s): Using standardized QI methodology & engaging infographics, we improved resident satisfaction with NICU orientation. NICU education experience also improved by creating standardized education goals with assigned dedicated teaching time during rotations. Our goal is to sustain the progress we have made.