Systems-Based Practice


During the 4th year of medical school, we are required to take part in a QI project. I had been looking for leadership opportunities, and volunteered to lead a group of my peers through this project. We reached out to an emergency physician, and decided to focus on reducing the use of MRI in the emergency department for non-emergent back pain. The project was broken into several steps. We first got a year’s worth of data from the ED to see how many patients coming in with the chief complaint of back pain received an MRI. We then did a convenience sample to see how often these patients actually had red flags indicating advanced imaging. Afterwards, we developed an informational flyer education providers on what these red flags are and how best to refer patients. Alongside this, we have been working with physical therapy to develop a faster referral for outpatient management of this back pain.

This was a huge learning experience for me, as I had never been part of a QI project before, and had never been a sole leader among my peers as in this manner. I learned a lot about communication skills, as it was initially difficult keeping everybody on the same page as we worked through the project. I realized I needed to provide frequent updates from both the faculty and peers to keep everyone connected. I also realized how difficult it can be to keep people working on the same timeline. With the craziness of COVID, it was difficult for our attending to keep track of our deadlines and work at the pace some students wanted to. It was also sometimes difficult to keep students on track, and I found myself sometimes picking up the slack for others. On top of this, I learned a ton about how to conduct a QI project. This is definitely a useful framework I will be able to use going forward.

My goals for this project are to successfully complete the presentation we have on March 11th. I also hope to follow this project beyond these due dates and provide assistance to the physician we were working with however I am able. My resources for attaining this goal will be my past experience with the project and all the analysis we’ve completed. This puts me in a strong position to provide assistance and bring others on to the project as needed.

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