Abstract
INTRODUCTION: Onboarding inefficiencies in student-run healthcare organisations can lead to unclear role expectations, inconsistent knowledge transfer and disruptions in leadership transitions. This quality improvement (QI) initiative evaluates the implementation of a standardised operating procedure (SOP) within Street Medicine Detroit (SMD), a medical student-run clinic, to improve onboarding and leadership continuity. METHODS: A QI initiative was developed to create an SOP based on retrospective surveys from past leaders, identifying key organisational challenges. Post implementation surveys assessed the SOP's impact on onboarding effectiveness, role clarity and preparedness. The project followed a Plan-Do-Study-Act cycle to guide the intervention and evaluate outcomes. RESULTS: The SOP improved new leader onboarding by reducing reliance on board members, increasing clarity of training materials and enhancing preparedness to lead from day 1. Leaders trained with the SOP reported fewer unanswered questions and greater self-reliance. Survey results indicated significant improvements in clarity and role understanding, with new leaders preferring to reference the SOP over informal knowledge transfer. DISCUSSION: The findings suggest that SOPs are an effective tool for improving operational efficiency and leadership transitions in student-led healthcare organisations. This intervention also integrated QI education, fostering leadership skills and systems-based thinking. The study highlights the applicability of this model to other healthcare settings. The implementation of an SOP at SMD successfully addressed long-standing onboarding inefficiencies, providing a scalable solution to improve leadership transitions. This model can be applied to other student-run clinics and healthcare organisations, enhancing both organisational efficiency and medical education.