(1073) Whole-System Approach to Improving the ICU Rotation Experience

Introduction: The ICU is a core experience in residency training. Few resources and attention is given to the design of the ICU resident curriculum and schedule. Lack of a whole-system design negatively impacts the quality of the clinical learning environment for residents, faculty, staff, and coordinators. Inconsistent coverage, subpar procedural experience and duplication of work negatively impacts resident recruitment and faculty satisfaction. The goals of this educational improvement project were to streamline and standardize the ICU resident rotation schedule and education curriculum.

Methods: Evaluation methods were designed to measure the impact of a structured network critical care education plan for all campuses with residents. Select items from the ACGME annual resident survey and the internal employee engagement survey were identified to evaluate changes in the clinical learning and work environment. Focus group meetings were conducted with residents, faculty, and ICU leadership to gain an understanding of the post-intervention impact on resident satisfaction, faculty teaching satisfaction, coverage, and procedural training experience.

Results: Network wide, 17 residency programs and over 50 attending faculty participated in this improvement project evaluation. Of the 235 housestaff, 81% rated the institution “very positively” on the 2023 ACGME survey compared to 72% in 2022. Furthermore, 77% of housestaff rated “impact of other learners on education” as favorable on the 2023 ACGME survey compared to 70% in 2022. Focus group meetings with residencies reported an overall better learning and procedural experience because of predictive ICU scheduling and consistency in number of learners in the ICU at any one time. ICU leadership reported improved and more consistent staffing. ICU attendings reported greater satisfaction and teaching experience with shared educational responsibilities and consistency of number of learners on a rotation at any one time.

Conclusions: Streamlining and standardizing the ICU resident rotation schedules and education curriculum positively impacts clinical learning and work environment. Switching to a 13 four-week block schedule and centralizing scheduling resources improved the reliability of the ICU education experience for all stakeholders.