Kaizen: Utilizing Rapid Transformational Business Quality Improvement Processes to Meet ACGME QI Guidelines

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Conference Proceeding - Restricted Access

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The American College of Graduate Medical Education (ACGME) requires that all programs train residents in quality improvement (QI). Specifically, 2017 revisions of the Common Program Requirements mandate that residents must receive training and experience in QI processes and must have the opportunity to participate in interprofessional QI activities. While no specific guidance is given by the ACGME to meet these requirements, all hospitals use QI processes to ensure optimal patient care is given and safety is preserved. Residency programs are left to their own devices in meeting these requirements, and most insert their residents into already-running programs.

Rather than piggy-backing onto an existent QI project, we chose to have our anesthesiology residents perform Kaizen QI projects to meet the aforementioned requirements. Kaizen is the Japanese word for improvement⋯literally translating to the phrase “good change”. In business, Kaizen refers to “continuous improvement” or “small incremental improvements” within all areas of a company. Given the quick turnaround of the Kaizen process, it lends itself well to our specialty, which is marked with brief but meaningful interactions with patients and staff.


As this was a departmental QI project and no patient identifiers were collected/viewed, IRB approval was waived. PGY-2 anesthesiology residents were required to complete Kaizen projects under the guidance of the department’s QI manager. A Kaizen is a day-long project that starts with a morning meeting with individuals from multiple disciplines. During this meeting the resident must identify a problem (or potential problem), design methodology for evaluating the system-based practices contributing to that problem, analyze work flow with an eye towards efficiency and safety, and finally create a solution and summary which they then present to surgery and anesthesiology QI personnel. Nearly all Kaizen solutions have been implemented, and resident and staff acceptance/satisfaction has been high.


All anesthesiology residents matriculating at our institution since implementation of this process have met ACGME requirements of QI project participation. They have done so in a multidisciplinary fashion, increasing the opportunities for interdepartmental collaboration, communication, and professionalism. Project evaluations by QI staff have been uniformly excellent, and resident evaluations of the process have been high as well.


The Kaizen process is an efficient means of teaching QI during anesthesiology residency, with a focus on rapid transformational change. ACGME guidelines are met, education is enhanced, and interdisciplinary relationships are improved


American Society of Anesthesiologists. The Annual Anesthesiology Meeting, October 2019, Orlando FL. Abstract Number: A4156, A2089