180 - Delivering Competency: QI Initiative to Increase Resident Delivery Attendance

Publication Number: 3173.180

Laurel A. Thomas, Akron Children's Hospital, Akron, FL, United States; Isaiah Noel, Akron Children's Hospital, Akron, OH, United States; Shine Kim, Akron Children's Hospital, Copley, MD, United States; Jessica M. Aguilar, Akron Children's Hospital, Broadview Heights, OH, United States; Samantha Gunkelman, Akron Children's Hospital, Akron, OH, United States; Michael T. Bigham, Akron Children’s Hospital, Akron, OH, United States

Background: The ACGME requires graduating pediatric residents to demonstrate competency in delivery room stabilization of newborns. Despite spending a total of 8 weeks in delivery rotations, the reported delivery attendance was low for graduating residents, hindering competence in newborn stabilization.

Objective: The resident QI team sought to increase the average number of neonatal deliveries attended and documented by 200% per resident per block.

Design/Methods: This quality improvement project took place within a large midwestern pediatric residency program at a free-standing children's hospital between July 2023 to June 2025. Participants included all pediatric residents during their required delivery rotations. The key interventions were the addition of a robust simulation curriculum, optimization of resident scheduling to maximize participation, and modified documentation process (See Figure 1). Data was collected via resident procedural logs to assess documented delivery attendance.

Results: There were a total of 26 rotational blocks studied with an average of 3-5 residents per block. The average deliveries attended and documented increased from 0.76 to 8.58 deliveries per resident per block, an increase of approximately 1100% (See Figure 2).

Conclusion(s): This resident QI project significantly improved the number of newborn deliveries attended and documented by pediatric residents on required delivery rotations. This is a model that is translatable to other required ACGME procedures and to other residency programs struggling to demonstrate competence in required procedures.

Figure 1
Key Driver Diagram with Key Drivers and Interventions (Active, Adopted, & Potential)

Figure 2
Control Chart Showing Average Number of Deliveries and Dates When Interventions Were Initiated