Article Text

Download PDFPDF
Developing capable quality improvement leaders
  1. Geraldine M Kaminski1,
  2. Maria T Britto1,2,3,
  3. Pamela J Schoettker1,
  4. Stacey L Farber4,
  5. Stephen Muething1,3,
  6. Uma R Kotagal1,3
  1. 1James M. Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
  2. 2Division of Adolescent Medicine, Center for Innovation in Chronic Disease Care, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
  3. 3Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
  4. 4Education Research and Measurement, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
  1. Correspondence to Dr Geraldine M Kaminski, Quality Improvement Systems, James M Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, MLC 5040, Cincinnati, OH 45229-3039, USA; gerry.kaminski{at}


Background/objective Cincinnati Children's Hospital Medical Center created the Intermediate Improvement Science Series (I2S2) training course to develop organisational leaders to do improvement, lead improvement and get results on specific projects.

Design methods Each multidisciplinary class consists of 25–30 participants and 12 in-class training days over 6 months. Instructional methods include lectures, case studies, interactive application exercises and dialogue, participant reports and assigned readings. Participants demonstrate competence in improvement science by completing a project with improvement in outcome and/or process measures. They present on their projects and receive feedback during each session and one-on-one coaching between sessions.

Results Since 2006, 279 participants in 11 classes have completed the I2S2 course. Participant evaluations have consistently rated satisfaction, learning, application, impact and value very high. Large and statistically significant changes were observed in pre-course to post-course self-assessment of knowledge of five quality improvement topics. Approximately 85% of the projects demonstrated measurable improvement. At follow-up, 72% of improvement projects were completed and made a part of everyday operations in the participant's unit or were the focus of continuing improvement work. Many changes were spread to other units or programmes. Most (88%) responding graduates continued to participate in formal quality improvement efforts and many led other improvement projects. Nearly half of the respondents presented their results at one or more professional conference.

Conclusions Through the I2S2 course, the authors are developing improvement leaders, accelerating the shift in the culture from a traditional academic medical centre to an improvement-focused culture, and building cross-silo relationships by developing leaders who understand the organisation as a large system of interdependent subsystems focused on improving health.

  • Clinical leader development
  • quality improvement
  • implementation science
  • physician education
  • nursing education
  • health professions education
  • healthcare quality improvement
  • implementation science
  • leadership
  • collaborative
  • breakthrough groups
  • comparative effectiveness research
  • continuous quality improvement
  • control charts
  • run charts
  • quality improvement methodologies
  • patient safety
  • paediatrics

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Funding Data used for this report were collected in part with the support of a grant from the Robert Wood Johnson Foundation, Evaluating Quality Improvement Training Programs 65 499. SF had financial support from the Robert Wood Johnson Foundation for analysis of the submitted work.

  • Competing interests There have been no financial relationships with any organisations that might have an interest in the submitted work in the previous 3 years, and no other relationships or activities that could appear to have influenced the submitted work.

  • Ethics approval Cincinnati Children's Hospital Medical Center Institutional Review Board.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Data are available on request from Uma R Kotagal at uma.kotagal{at}