Duke Internal Medicine residents receive comprehensive training in quality improvement (QI) and patient safety (PS) through a structured, hands-on curriculum embedded across all years of training.
What You Will Learn
- Improving Clinical Outcomes - use data-driven methods to enhance patient care and outcomes
- Analyzing Safety Events - identify root causes and implement system-level solutions
- Structuring Improvement Efforts - understand designing team-based quality improvement initiatives across care settings
- Delivering High-Value Care - optimize care quality while reducing unnecessary utilization
Key Features of the Duke QI & Patient Safety Curriculum
Residents build core skills through workshops, conferences, and clinical experiences, including:
- Continuous quality improvement methods
- Safety event analysis and reporting
- Team-based care and communication
- Culture of safety principles
Training is integrated into:
- Intern and resident conferences
- Morbidity & Mortality (M&M) conferences
- Inpatient general medicine rotations
- Continuity clinic panel management
Residents actively analyze real patient safety events using structured tools.
Examples include:
- Intern Safety Reports: Monthly discussion review of safety events submitted by Internal Medicine trainees
- Senior Resident Safety Reports: Case-based analysis of quality or safety issues integral to inpatient care
- Learning from Defects Tool: Structured approach to identifying system improvements
Residents receive individualized performance data to guide care for their patient panels.
- Dashboard-based feedback of patient panels
- Clinic comparison and benchmarking
- Training in Epic tools such as SlicerDicer
- Development of personalized SMART goals
All residents participate in hands-on quality improvement initiatives.
- Upper-level residents complete shared program-wide QI projects
- Projects follow the Model for Improvement framework
- Focus areas include preventative care, chronic disease management, and high-value care
Recent project topics include:
- USPSTF guideline-based screening
- Diabetes management
- Lipid management by cardiovascular risk
- Goals of care conversations
- Colorectal cancer screening
Resident Leadership in Quality & Safety
Residents lead and design improvement initiatives through the Internal Medicine Residency Patient Safety & Quality Council (PSQC)—a resident-led group focused on advancing patient safety and care delivery.
Key activities:
- Identifies system-level quality and safety opportunities
- Supports project design and implementation
- Connects residents with faculty mentors and institutional resources
- Promotes a culture of continuous improvement
Recent PSQC initiatives include:
- Improving inpatient lab utilization and fever workups
- Enhancing paging and communication practices
- Strengthening discharge medication reconciliation
Mentorship & Career Development in QI
Residents interested in advancing training can:
- Work with faculty mentors across Duke Health
- Participate in institutional QI and safety initiatives through the GME-wide Patient Safety and Quality Council
- Explore the intersection of QI and technology through the Digital Health Training Program (DHTP)
Integrated, Longitudinal Learning Model
- Intern Year: Foundational concepts and group learning
- PGY-2 Year: Individual performance improvement projects
- PGY-3 Year: Advanced project work and leadership opportunities
This progression ensures graduates are prepared for future improvement efforts in any clinical environment.
QI & Patient Safety Leadership
Joel Boggan, MD, MPH
Associate Program Director, Quality Improvement & Patient Safety
Associate Professor of Medicine, Division of Hospital Medicine
Provides strategic oversight of the curriculum and:
- Mentors residents in QI projects
- Coordinates educational programming
- Aligns residency efforts with health system priorities
Samantha Menegas, MD
VA Chief Resident, Quality & Safety
Internal Medicine, Class of 2026
Leads implementation of QI initiatives and:
- Supports resident education and project development
- Oversees the Patient Safety & Quality Council
- Partners with Duke and VA leadership
Why Duke for QI & Patient Safety Training?
Duke’s program stands out for its:
- Hands-on, experiential approach
- Access to real-time clinical data
- Resident-led leadership opportunities
- Strong mentorship and institutional support
- Integration with health system priorities
Duke residents graduate equipped to play instrumental roles in healthcare delivery and patient safety.