Learning to make a difference: introducing quality improvement methods to core medical trainees.

The 'Learning To Make a Difference' (LTMD) initiative was a Royal College of Physicians/Joint Royal Colleges of Physicians Training Board collaboration supported by The Health Foundation. It aimed to support the learning and development of new and relevant skills in quality improvement (QI) methodology by trainees to enable them to deliver effective QI projects at the frontline. Core medical trainees in five deaneries were offered the opportunity to undertake a QI project in place of a mandatory clinical audit during 2010-2011. In total, 61 trainees completed 46 QI projects. Evaluation of the project outcomes demonstrated the acceptability, feasibility and strengths of trainee-led small-scale change and how this can deliver improvement in the quality of multidisciplinary working, clinical practice and patient care. The LTMD project supports the further development and spread of this approach, encouraging all physician trainees, and their supervisors, to understand, develop and embed appropriate skills in QI methodology as part of their professional role. In addition, the project has identified the necessary infrastructure to enable this to happen.