There is a generally-accepted truism about residents, which is that they are “crazy busy.” They endure this extreme busyness because they are passionate about what they are working toward: careers in medicine or surgery.

Two crazy-busy residents, Molly Kantor, MD, and Daniel Fang, MD, are passionately interested in quality improvement (QI) in medicine. They recently made a significant contribution to Stanford residents when they produced the first edition of Quality Improvement News which, according to Kantor, “we thought would be a good forum to distribute information to residents and also solicit feedback about ongoing QI projects.”

She continues: “Both Daniel and I have had very positive experiences becoming involved in QI over the past two years and especially through the QI elective, but we noticed that some residents were unaware of QI projects and opportunities at both Stanford and the VA.”

Fang picks up the story: “One goal of the newsletter was to increase bi-directional communication between residents and hospital QI leadership. In addition, we wanted to ensure all housestaff were informed of the quality improvement projects most relevant to residents, particularly those that involve changes to daily workflow. Finally, we wanted a way to showcase QI projects done by our own residents.”

Issue #1 has one article on the implementation of tablet computers for residents at the VA to use when rounding, for writing orders, and for education. This is the result of an effort by Annie Postolova, MD, to improve efficiency at the VA, and the reaction to the tablets has been positive from both residents and patients.

The inaugural issue also has shorter notices about daily management huddles of 5-10 minutes that are designed to relieve minor inconveniences and discuss minor issues; the addition of a pharmacist to each general medicine team to help with reconciling medications and verifying orders; and an introduction to a checklist that helps residents remember all the things that have to happen during discharge of a patient from the hospital.

The newsletter is likely to fulfill other purposes. Kantor points out two possibilities: “Since residents rotate through many sites, it can be hard to keep track of which projects and changes are happening when and where, so the newsletter helps clarify this. And because residents are the front-line workers whose work is often affected by changes, residents are in a position to offer valuable insights and solutions.”

The reception that Quality Improvement News received is all the encouragement Fang and Kantor needed. Fang reports that “many individuals commented on the usefulness of having a way to consolidate and track residency-relevant projects.”

So, given all that success, what next? “Currently we plan to release one to two issues every quarter, though ultimately it will depend on a balance between resident interest and how frequently new projects are released.”

Crazy busy is clearly a good place to be. Ask Daniel Fang and Molly Kantor.