Building sustainable QI capacity through a regional QI education programme: lessons from 8 years of experience with London paediatric resident doctors

IntroductionSince 2018, the NHS London Specialty School of Paediatrics has collaborated with QIClearn (an independent organisation) to design and deliver a structured Quality Improvement (QI) education programme for postgraduate resident doctors in the region to build QI capacity. The programme (QI Change Champions) has been designed not only to equip resident doctors with core improvement skills but, uniquely, to secure its own future through a novel, scalable approach to faculty and mentor development. This paper outlines the experience and learning from this programme, discusses transferable lessons and the potential contribution to the wider field of QI education.MethodWe believe we have developed an innovative and sustainable model for embedding essential QI capability into postgraduate training for resident doctors in a region. We have observed QI in practice by constantly reflecting, learning and adapting our approach. Although this is not a formal programme evaluation, we have described our work in practice and the themes captured from mentor and learner feedback used to continually improve the programme. The analysis was designed to mitigate bias, in view of the fact that QIClearn was receiving payment as a company, and the faculty who co-designed the programme were educators for the London Specialty School of Paediatrics and not employed by QIClearn.ResultsWe have enrolled 254 resident doctors across 16 iterations (2 per year) to equip them with the skills to deliver meaningful change in the NHS. We recognised early on that sustainable QI education depends on development of a faculty development pipeline. We have trained 14 mentors selected from those who completed the programme who demonstrate particular skill in motivating others and understanding of QI methodology.DiscussionOur novel Mentor in Training model has enabled us to both expand our regional QI capacity and develop the next generation of clinical leaders and educators. We have built on the growing field of evidence for near-peer mentors in medical education and developed a real community of practice to support our learners. We suggest that there are long term benefits to building this community but this is an area that needs to be explored further in future research..