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Pediatrics. 2018 Nov;142(5). pii: e20180712. doi: 10.1542/peds.2018-0712. Epub 2018 Oct 9.

Pediatricians' Participation in Quality Improvement at the Time of Enrollment in MOC.

Author information

Division of General Pediatrics, Department of Pediatrics and Communicable Diseases,
Department of Health Management and Policy, School of Public Health, and.
Child Health Evaluation and Research Center, University of Michigan, Ann Arbor, Michigan.
Division of General Pediatrics and Adolescent Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
Division of Pediatric Emergency Medicine, Department of Emergency Medicine, School of Medicine.
Division of General Pediatrics, Department of Pediatrics and Communicable Diseases.
American Board of Pediatrics, Chapel Hill, North Carolina; and.
School of Medicine, Tufts University, Boston, Massachusetts.



Although national bodies have proclaimed the importance of incorporating quality improvement (QI) into the daily fabric of clinical care, the actual proportion of practicing pediatricians who participate in QI activities on an annual basis is unknown. Correspondingly little is known about pediatrician motivations for, attitudes about, and support received for QI participation.


Pediatric diplomates enrolling in the American Board of Pediatrics' Maintenance of Certification program during calendar year 2016 were provided with the opportunity to complete a brief survey. A portion of the survey was focused on issues related to participation in QI programs.


Survey responses were received from 8714 of the 11 890 diplomates who enrolled in Maintenance of Certification in 2016 (response rate: 73.3%). Overall, 86.6% of respondents reported participation in at least 1 QI project in the previous year. There was variation in previous-year participation in a QI project by practice affiliation categories, ranging from 79.9% for nonacademic generalists to 92.4% for academic specialists. The extrinsic requirement for QI to maintain board certification was the dominant motivator among all respondents (50.7%), followed by 2 intrinsic factors: identify gaps in practice and implement change (40.3%) and opportunity to collaborate with others (36.9%).


Although the results are encouraging, despite almost 2 decades of national attention to the quality of health care and efforts to embed continual QI in health care delivery activities, ∼1 in 5 nonacademic pediatricians and 1 in 10 academic pediatricians did not report participating in any QI activities in the previous year.


Conflict of interest statement

POTENTIAL CONFLICT OF INTEREST: Dr Leslie is employed by the American Board of Pediatrics; the other authors have indicated they have no potential conflicts of interest to disclose.

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