Abstract: SA-PO0987
Establishing a Structured Quality Improvement Curriculum and Operational Program in Nephrology Fellowship Training
Session Information
- Educational Research
October 24, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Educational Research
- 1000 Educational Research
Authors
- Hussein, Wael F., The University of Tennessee Health Science Center College of Medicine, Memphis, Tennessee, United States
- Hastings, Margaret Colleen, The University of Tennessee Health Science Center College of Medicine, Memphis, Tennessee, United States
- Kovesdy, Csaba P., The University of Tennessee Health Science Center College of Medicine, Memphis, Tennessee, United States
Background
Practical exposure to quality improvement (QI) during nephrology fellowship training is often inconsistent and fragmented. Many fellow QI projects are limited to isolated projects without standardized infrastructure, operational integration, or sustained processes. We aimed to establish a structured, fellow-led nephrology QI program integrating real-world clinical improvement initiatives, standardized processes, and longitudinal Plan–Do–Study–Act (PDSA) methodology.
Methods
A formal nephrology fellow QI program was established within an academic nephrology division under dedicated faculty leadership. Standardized data collection infrastructure and operational workflows were developed. Fellows received training in data collection standardization, chart abstraction, workflow evaluation, and PDSA methodology.
Initial projects focused on (1) Evaluation of SGLT2 inhibitor utilization in CKD clinics and (2) Assessment of continuous renal replacement therapy (CRRT) circuit performance and anticoagulation practices in ICUs.
Results
Six nephrology fellows participated across three healthcare systems and multiple inpatient and outpatient nephrology practice settings. Standardized REDCap databases and abstraction tools were successfully implemented for both projects. Institutional QI and regulatory pathways were established across participating sites, including IRB processes and VA QI determinations.
Baseline data collection was successfully completed for both QI projects. Multidisciplinary stakeholder engagement was established with nephrology faculty, ICU teams, pharmacists, and institutional quality leadership. Early operational challenges identified included variability in institutional QI oversight processes, coordination across multiple electronic health record systems, and limited protected fellow and faculty time.
Conclusion
Establishment of a structured fellow-led nephrology QI program across multiple inpatient and outpatient practices was feasible and enabled integration of QI initiatives into fellowship training. Standardized infrastructure, multidisciplinary collaboration, and longitudinal PDSA-based frameworks supported development of sustainable QI processes. This model may provide a scalable framework for integrating operational quality improvement and implementation training into nephrology fellowship programs.