Despite it being 20 years since the Institute of Medicine reported poor quality and high variability in healthcare delivery, there are still significant opportunities for clinical quality improvement (QI). As frontline clinicians and future healthcare leaders tasked with driving these changes, resident physicians are an important cohort to equip with knowledge, skills, and experience in QI and patient safety.
In this article, Mitchel and Li review the barriers to resident engagement, leadership and success with QI initiatives and propose potential solutions. Several barriers are unique to psychiatric training. The barriers described are broadly categorised as either structural or process-related, a distinction derived from Donabedian who described a framework for understanding the causal relationship between structures, processes, and outcomes in QI. In addition, the authors provide an example of a resident-led QI initiative to illustrate the proposed solutions.