Posted: March 20, 2014

Engaging Residents and Fellows To Improve Institution-Wide Quality: The UCSF Resident and Fellow Quality Improvement Incentive Program


In 2006 UCSF Medical Center together with the UCSF Office of Graduate Medical Education began including
residents and fellows in our Incentive Achievement Program (IAP). Prior to 2006 the institution supported an
IAP which was limited to non-physician staff. With increased emphasis on interprofessional care teams, and
recognition of the essential role that resident physicians play as front-line providers in many situations, the
program was expanded to include resident physicians. The program, now called the Residents and Fellows
Quality Improvement Incentive Program (RFQIIP), provided financial rewards for achievement of medical
center benchmark goals. The program quickly evolved and by 2009 we added a new component focused on
program-specific goals in addition medical center-wide goals. The goal of this change was to further engage
residents and fellows and to identify project goals more proximal to their experiences. There was a specific
recognition that while some goals were relevant to all trainees (e.g. patient satisfaction), other goals might apply
very differently to different specialties (for example, radiology and lab medicine residents might not be able to
improve pain control scores, or pediatrics trainees might not care for patients with acute myocardial infarction).
Currently, all residency and fellowship programs have the opportunity to submit program-specific goals, and
15-20 programs do so each year. These goals are vetted by a committee of quality improvement and education
leaders from UCSF Medical Center, UCSF Benioff Children's Hospital, and UCSF School of Medicine. Goals
are for a single academic year, and tied to financial rewards. These are in addition to medical center-wide goals,
for while all eligible trainees may receive an incentive payment.


GME, Quality Improvement, Resident Incentives, Incentive Program, Incentive Payment


Glenn Rosenbluth, MD, UCSF Benioff Children’s Hospital; University of California, San Francisco Medical Center