Teaching quality improvement in occupational medicine: improving the efficiency of medical evaluation for commercial drivers

J Occup Environ Med. 2015 Apr;57(4):453-8. doi: 10.1097/JOM.0000000000000394.

Abstract

Objective: To describe a successful, resident-led quality improvement (QI) project that improved the efficiency of the Department of Transportation (DOT) medical examination process.

Methods: After learning QI principles through didactics, workshops, and online modules, residents led a QI project to streamline the process of the DOT examination. An interdisciplinary group of key stakeholders collaborated to analyze the process and to design and implement interventions.

Results: Following the Model for Improvement and Lean concepts, residents ran seven Plan-Do-Study-Act cycles over a 4-month period with multiple iteration and testing changes. Compared with the baseline, the team successfully reduced the total visit time (from check-in to check-out) by 28 minutes (102 minutes vs. 130 minutes; P < 0.001). The accuracy of certificate issuance, as proxy for quality of the examinations, improved after the interventions.

Conclusions: Residents successfully improved the efficiency of the DOT examination process.

MeSH terms

  • Automobile Driving*
  • Curriculum
  • Efficiency, Organizational
  • Humans
  • Internship and Residency*
  • Minnesota
  • Occupational Medicine / education*
  • Physical Examination / economics
  • Physical Examination / methods
  • Physical Examination / standards*
  • Process Assessment, Health Care
  • Quality Improvement*
  • Time Factors