Objective: To evaluate a multi-tiered approach to incorporating QI and PS training and participation in a pediatrics residency program. Methods: We developed a multi-tiered approach to QI/PS training during the 2013-14 year, and expanded upon it during subsequent years. We tracked resident participation in Departmental QI Grand Rounds and ACGME and Department survey results. The initial intervention involved didactic and small group sessions/to facilitate project development. We also instituted Departmental QI Grand Rounds. In the following year (2014-15), we increased the number of didactics and started a practice improvement project within the resident group practice where residents were provided individualized practice data. In 2016-17, we added an adapted Team-Based Learning session for PGY-1’s and all residents were required to complete on-line Institute for Healthcare Improvement modules. Results: In 2013/14, 26 residents presented 2 oral and 12 poster presentations at QI Grand Rounds. This increased to 36, 2 & 14 in 2014/15, 43, 3 & 17 in 2015/16, and 26, 2 & 13 in 2016/17. In 2012/13, 50% of residents responded affirmatively to the ACGME survey question \u27participated in QI\u27; (19% affirmed they were \u27provided data about practice habits\u27). This increased to 86(29) in 2013/14; 81(48) in 2014/15, 83(42) in 2015/16, and 78(48) in 2016/17. Conclusions: We have implemented a multi-pronged QI curriculum that includes all resident levels. Results demonstrate increased resident involvement. Key to buy-in is the ability to participate in high-interest projects within self-designated tracts. Future directions include further study of the curriculum and of the system/patient safety outcomes
