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Strategy Submission

Interprofessional Curriculum in Patient Safety and Quality Improvement

Author:

Leslie W. Hall

M.D.

Title:

Associate Professor of Clinical Internal Medicine

Coauthors:

Susan Scott, RN, MSN; Patient Safety Coordinator, Univ of Missouri Health Care; Columbia, MO, USA Karen R. Cox, RN, PhD; Manager of Quality/Safety at Univ of Missouri Health Care; Columbia, MO, US

Institution:

University of Missouri - Columbia

Email:

Competency Categories:

Patient-Centered Care, Quality Improvement, Safety, Teamwork and Collaboration

Learner Level(s):

Pre-Licensure BSN

Learner Setting(s):

Classroom

Strategy Type:

Case Studies

Learning Objectives:

At the completion of this four week course, you should be able to demonstrate the following knowledge and skills in patient safety, quality improvement and teamwork:

Patient Safety:

  • Define a medical error, adverse event, and near miss
  • Describe typical responses to medical error
  • Describe rationale for standardization of routine procedures and processes
  • Describe contributing factors to medical error
  • Identify root causes, contributing factors and corrective strategies following review of an adverse event

Quality of Care:

  • Identify the six Institute of Medicine aims for quality care
  • Describe and explain basic quality improvement/change concepts o Care as a process o Developing an aim statement for an improvement project o Collection of baseline and process data (numerator and denominator)
  • Describe how both medical and process improvement knowledge are needed for health care improvement
  • Identify and critique the gap between current practice and best practice
  • Demonstrate problem solving on behalf of a known quality gap
  • Generate a process flow map for a given care process
  • Identify aim/goal statement
  • Identify one key measurement to track progress
  • Identify one key measurement to evaluate intervention

Teamwork:

  • Describe strengths that various health professions bring to patient care, and articulate why and how various health professions must work together within a health care team to achieve improvement
  • Describe necessary elements of effective teamwork
  • Describe necessary elements of effective team leaders
  • Identify key interpersonal skills that facilitate effective teamwork
  • Participate in team critique

Strategy Overview:

The described curriculum is designed to be used with health professional students of all types who are brought together to review a health care incident in which an adverse event occurred. We have used this curriculum with nursing students (senior undergraduate students in final semester), second year medical students, second year health management students, and respiratory therapy students. After one introductory session, all further work in this curriculum is conducted in interprofessional small groups. We have typically assigned two facilitators to each small group (ideally representing two different health professions); however, this is intended to be student-led problem based learning, and students are typically given as much control of the learning process as possible. Working with students of other professions, learners are asked to analyze the event and determine the underlying root causes. They are then challenged to propose system changes that might prevent similar events in the future. They are asked to analyze the impact of proposed system changes, then choose one of the changes for additional focus, designing an aim statement and metrics for a proposed improvement project. At the end of the course, each small group is asked to summarize their analysis of the assigned case to a group of their peers (see attached PowerPoint template). This curriculum has evolved over five years, gradually becoming more successful. Elements that seem to engender success are: (1) Problem-based learning format, (2) Minimizing lecture time and maximizing small group time, (3) Requirement for presentation at the end of the course, which helps to fully engage students in the process. Challenges in delivery of this course include scheduling class time when all learners can be present (requires planning 6 to 12 months in advance), differences in levels of clinical experience among the learners, and differing attitudes about patient safety that learners bring into the sessions.

Submitted Materials:

Additional Materials:

Interprofessional_Curriculum_in_Patient_Safety_and_Quality.doc (147Kb)
Safety_and_Quality_Attitudes_Survey.doc (101Kb)
Pt_Safety_and_QI_Project_Presentation.ppt (67Kb)

Evaluation Description:

Participant attitudes regarding quality, safety and teamwork assessed for all learner types (nursing, medicine, health management) before and after completion of the curriculum (see attached file). End of course evaluations completed by learners. Elements of the curriculum are included in knowledge-based examination for all involved students.
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