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

Abstract

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