Leadership in Quality Improvement Pathway

The Leadership in Quality Improvement Pathway was designed in line with the residency’s mission to prepare residents to become innovative leaders in health care. The pathway takes advantage of the internationally renowned Virginia Mason Production System (VMPS) to train residents in rigorous quality improvement methodology, leadership, and change management through one-on-one coaching and mentorship.

The Virginia Mason internal medicine residency curriculum consists of core inpatient rotations, ambulatory experiences including full-day continuity clinic and ambulatory blocks, customizable electives and high-yield conferences. The program has excellent adherence to ACGME duty hour limits, maximizing clinical time and supporting our mission to train excellent physicians, fulfilled individuals and innovative leaders. In addition to the internal medicine curriculum, the QI pathway includes additional training and classwork with the goal of creating residents as leaders and innovators of change highlighted by a culminating quality improvement project by the end of PGY-3.

Residents in the Leadership in QI Pathway will attend classes in quality improvement taught by in-house experts in the Virginia Mason Production System (VMPS). These classes compose the "VMPS for Leaders" curriculum, which is used to train leaders throughout the organization in VMPS methods. This course is now offered remotely. After the introductory course during first year, you will attend an intensive one-week in-person course “Leading at Virginia Mason” where you will work alongside fellow leaders in training and experts in the VMPS process within the Kaizen Promotion Office. Homework from each class will give residents a chance to apply their learning in a real clinical environment. This curriculum will give residents the foundation they need to complete a capstone quality improvement project.

In the first year, residents will start taking VMPS for Leaders classes during elective time and will also complete the Systems-Based Practice rotation. During this rotation, they will participate in a quality improvement event, attend a Patient Safety Alert (PSA) resolution meeting, participate in a “flow tour” and attend weekly "report out" sessions and "stand up" meetings to learn more about improvement work throughout the organization, and meet with various quality leaders in the organization.

During the end of the first year and beginning of the second year, residents are expected to start working on a Capstone Project. They will select a process and apply VMPS tools to gather data on the current state, identify waste, and develop team leadership and facilitation skills. After the initial data-gathering state, residents will lead a team first through a formal two-day event to generate and test ideas for improvement, and then through the post-event implementation process.

After finishing the Capstone Project, residents will gather post-event data to measure the effect of the changes they’ve implemented and present their results. Results may then be submitted as an abstract to be presented at a major conference or published in a quality improvement journal.

Throughout the three years, residents will receive extensive coaching and mentorship. Early in the first year, they will meet with leadership and advisory members of the QI track who are also former VMPS for Leaders graduates. They will be introduced to various potential mentors within the organization depending on their area of interest. In the beginning of their second year, residents will pick a sponsor for their Capstone Project after completion of the “Leading at Virginia Mason” course, who will help guide them through the process and assist in planning and implementation. In addition, residents will be assigned a coach from the Kaizen Promotion Office (KPO) who specializes in VMPS methods. Residents will report regularly on their project work progress to their KPO coach, who will work with them one-on-one to learn how to apply VMPS tools to their chosen project. Third year residents who have completed VMPS for Leaders will be expected to serve as mentors for first and second year residents, as well.

In addition to the experience of planning and leading a quality improvement project, residents will meet with key physician, and non-physician, leaders throughout Virginia Mason. They will have the opportunity to attend classes to further hone their skills alongside other leaders in the organization. In addition, residents in the pathway will play a key role in mentoring other residents and promoting overall residency involvement in quality improvement activities. 

The ideal applicant for the pathway would have a passion for quality improvement and be willing to take initiative and work independently. Residents interested in the Leadership in QI Pathway must first match into either the categorical or primary care tracks. After matching at Virginia Mason, residents will be given the opportunity to apply during their first year of training.