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VHA National Center for Patient Safety

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Chief Resident for Quality and Patient Safety Program

Program Vision:

"To be the leading health professions education program in quality improvement and patient safety."


Death due to medical error is thought to be the fourth leading cause of death in the United States of America.

The VA Chief Resident in Quality Improvement and Patient Safety Program (CRQS) is a nationally recognized training program the equips physicians with the skills necessary to safeguard and prevent unintended harm from occurring during healthcare delivery.

The program is a 1-year, full-time, training program (July 1 - June 30) for physicians from various medical specialties including Internal Medicine, Surgery, Psychiatry, Radiology, Family Medicine, Emergency Medicine, PM&R, and more to learn Quality Improvement and Patient Safety (QI/PS). There are now over 110 positions awarded across 60 VA medical centers with academic affiliations.

The program trains Chief Residents with the knowledge, skills, and attitudes necessary to become future leaders in QI/PS and High Reliability Organization (HRO) methodology through education in Leadership, Patient Safety, and Continuous Process Improvement.

CRQS spend their year focusing upon learning, applying, and teaching quality improvement and patient safety principles with no more than 25% of their time in clinical duties at the VA medical center.

The program serves as a career launching point as our alumni secure competitive fellowships and future VA clinical leadership positions post-graduation that utilize these critical skills.

Receive Training in:

  • Quality Improvement
  • Safety Culture (Just Culture)
  • High Reliability Organizations
  • Measuring and Analyzing QI/PS metrics
  • Root Cause Analyses
  • Proactive Risk Assessments
  • Leading interdisciplinary healthcare improvement teams
  • Change Management
  • Educating healthcare staff in QI/P

Program Curriculum

The CRQS experience is captured through the completion of a summative program portfolio completed by each chief during their academic year consisting of:

  • Completing and presenting a year-long improvement project
  • Completing 5 Entrustable Professional Activities based on program milestones (similar to ACGME Milestones)
  • Attending National NCPS training in:
    • Team Training
    • Root Cause Analysis
    • Proactive Risk Assessment
  • Attending National curriculum including participation in:
    • July virtual orientation
    • "QI 101" rapid introduction to QI methods
    • Program-wide in-person conference
    • Biweekly online lecture series from national faculty experts
    • Biweekly small groups (called "Dens") with project mentorship
    • Project works in progress sessions and office hours
  • Presenting their capstone project to local and VISN leadership

Articles on AFPS:

  1. Cox LM, Fanucchi LC, Sinex NC, Djuricich AM, Logio LS. Chief Resident for Quality Improvement and Patient Safety: A Description. American J of Med. 2014;127(6):565-568.
  2. Watts BV, Paull DE, Williams LC, Neily J, Hemphill RR, Brannen JL. Department of Veterans Affairs Chief Resident in Quality and Patient Safety Program: A Model to Spread Change. American Journal of Medical Quality. 2016;31(6):598-600. doi:10.1177/1062860616643403
  3. Butcher RL, Carluzzo KL, Watts BV, Schifferdecker KE. A Guide to Evaluation of Quality Improvement and Patient Safety Educational Programs: Lessons From the VA Chief Resident in Quality and Safety Program. American Journal of Medical Quality. 2019;34(3):251-259. doi:10.1177/1062860618798697
  4. Aboumrad M, Neily J, Watts BV. Teaching Root Cause Analysis Using Simulation: Curriculum and Outcomes. J Med Educ Curric Dev. 2019 Dec 18;6:2382120519894270. doi: 10.1177/2382120519894270. PMID: 31897434; PMCID: PMC6920588
  5. Aboumrad, Maya MPH; Carluzzo, Kathleen MS; Lypson, Monica MD, MHPE; Watts, Bradley V. MD, MPH. Career Impact of the Chief Resident in Quality and Safety Training Program: An Alumni Evaluation. Academic Medicine 95(2):p 269-274, February 2020. | DOI: 10.1097/ACM.0000000000002938