1. patient safety curriculum guide: multi-professional edition PDF

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Summary

Health-care outcomes have significantly improved
with the scientific discoveries of modern medicine.
However, studies from a multitude of countries
show that with these benefits come significant
risks to patient safety. We have learnt that
hospitalized patients are at r...

Description

Part A Teacher’s Guide Patient Safety Curriculum Guide: Multi-professional Edition

1. Background Why do health-care students need patient safety education? Health-care outcomes have significantly improved with the scientific discoveries of modern medicine. However, studies from a multitude of countries show that with these benefits come significant risks to patient safety. We have learnt that hospitalized patients are at risk of suffering an adverse event, and patients on medication have the risk of medication errors and adverse reactions. A major consequence of this knowledge has been the development of patient safety as a specialized discipline to assist health-care professionals, managers, health-care organizations, governments (worldwide) and consumers who must become familiar with patient safety concepts and principles. Everyone is affected. The tasks ahead of health care are immense and require all those involved in care to understand the extent of harm to patients and why health care must move to adopt a safety culture. Patient safety education and training is only beginning to occur at all levels. Health-care students, as future providers of health care and health-care leaders, must prepare themselves to practise safe care. Though the curricula of the different health-care professions are continually changing to accommodate the latest discoveries and new knowledge, patient safety knowledge is different because it applies to all areas of practice and to all professions. Health-care students will need to know how systems impact on the quality and safety of health care, how poor communication can lead to adverse events and much more. Students need to learn how to manage these challenges. Patient safety is not a traditional stand-alone discipline; rather, it is one that integrates into all areas of health care. The World Health Organization’s (WHO) Patient Safety programme, and other projects such as this one, aims to implement patient safety worldwide. Patient

safety is everyone’s business and ranges from patients to politicians. As health-care students are among the future leaders in health care, it is vital that they are knowledgeable and skilful in their application of patient safety principles and concepts. The multi-professional edition of the WHO Patient Safety Curriculum Guide sets the stage for students, irrespective of their chosen profession, to begin to understand and practise patient safety in all their professional activities. Building students’ patient safety knowledge needs to occur throughout the entire education and training of health-care students. Patient safety skills and behaviours should begin as soon as a student enters a hospital, clinic or health service. By getting students to focus on each individual patient, having them treat each patient as a unique human being, and using their knowledge and skills carefully, students themselves can be role models for others in the health-care system. Most health-care students have high aspirations when they enter into their chosen field, but the reality of health-care systems sometimes deflates their optimism. We want students to be able to maintain their optimism and believe that they can make a difference, both to the individual lives of patients and the health-care system.

How to use this Curriculum The Curriculum has been designed for health-care educational institutions to implement patient safety learning for students prior to becoming qualified health-care professionals. Faculties can introduce all the topics as a whole or they can start more slowly by introducing one or more at a time. Each topic has all the underpinning knowledge required to teach the subject including suggestions for assessment. We have inserted case studies to facilitate learning and encourage teachers and instructors to include them in their teaching activities. We have also provided different ideas about how to teach a particular

WHO Patient Safety Curriculum Guide: Multi-professional Edition

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topic. Many of the topics are best delivered once the student has experienced their professional work environment as so much of patient safety learning requires a team approach and observation of the health service as a whole, not just the area where the student happens to be placed. The topics have been designed so that students can be responsible for much of their own learning through reading online material that provides them with the underpinning knowledge required, followed by tasks that can be performed to put the acquired knowledge into practice. We encourage the different faculties and health professions to add relevant professional literature and data to the topics that directly concern their profession. For example, we would expect that relevant pharmacy articles and data collections be included for pharmacy students. Because this is a Multi-professional Curriculum Guide we were unable to provide examples for all professions, but we have included as many as possible where available and relevant.

What is the Curriculum Guide? The Curriculum Guide is a comprehensive programme for the implementation of patient safety education in health-care educational institutions worldwide. It comprises two parts. Part A is a teacher’s guide, which has been designed to assist teachers to implement the Curriculum Guide. As we are aware that patient safety is a new discipline and many health-care professionals and faculty staff will be unfamiliar with many of the concepts and principles, this part lays the foundations for capacity-building in patient safety education. Part B provides a comprehensive, ready-to-teach, topic-based patient safety programme that can be implemented either as a whole or on a per topic basis.

Why was the Curriculum Guide developed? Since the Harvard study [1] in 1991 first described the extent of harm to patients, other countries have reported similar results, notwithstanding the differences in their cultures and health systems. The realization that health care actually harms patients has increased scrutiny of patient care in the context of an increasingly complex health system. This complexity has been intensified by rapidly changing medical technology and service demands [2,3]. Doctors, nurses, midwives, dentists, pharmacists, and other health-care professionals are expected to manage this complexity in their daily work, provide evidence-based health-care services, and maintain a safe environment for patients. However, unless

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Part A 1. Background

they are properly educated and trained in patient safety concepts and principles they will struggle to do this. Patient safety education for health-care professionals in the higher education sector has not kept up with workforce requirements [3-7]. For example, incident reporting systems for medication errors or surgical mistakes have been in use for many years in several countries, but accounts of specific curricula related to health-care errors or patient safety courses embedded in undergraduate education have started to be described only recently in the published literature [5,8]. A number of factors have impeded patient safety education. First, the lack of recognition by health-care educators that teaching and learning patient safety should be an essential part of the undergraduate curricula for health-care students, and that patient safety skills can be taught [9,10]. Many educators are unfamiliar with the literature and are unsure how to integrate patient safety learning into existing curricula [11,12]. Second, educators need to be open to new areas of knowledge [3]. One of the difficulties in introducing new curricula is a reluctance to address knowledge that originates from outside one’s profession, such as systems thinking and qualityimprovement methods [10]. It has also been suggested that the historical emphasis on treatment of disease rather than prevention of illness creates a culture that finds it difficult to give merit to a “non-event”, i.e. a preventable adverse event [3]. A third factor relates to entrenched attitudes regarding the traditional teacher-student relationship - one that may be hierarchical and competitive [9] and where an “expert” disseminates information to the student [3,4]. This Curriculum Guide seeks to fill the gap in patient safety education by providing a comprehensive curriculum designed to build foundation knowledge and skills for all health-care students that will better prepare them for clinical practice in a range of environments. References

1. Brennan TA et al. Incidence of adverse events and negligence in hospitalized patients: results of the Harvard Medical Practice Study I. New England Journal of Medicine, 1991, 324:370–376. 2. Runciman B, Merry A, Walton M. Safety and ethics in healthcare: a guide to getting it right, 1st ed. Aldershot, UK, Ashgate Publishing Ltd, 2007. 3. Stevens D. Finding safety in medical education. Quality & Safety in Health Care, 2002,11:109–110.

4. Johnstone MJ, Kanitsake O. Clinical risk management and patient safety education for nurses: a critique. Nurse Education Today, 2007, 27:185–191. 5. Patey R et al. Patient safety: helping medical students understand error in healthcare. Quality & Safety in Health Care, 2007, 16:256–259. 6. Singh R et al. A comprehensive collaborative patient safety residency curriculum to address the ACGME core competencies. Medical Education, 2005, 39:1195–1204. 7. Holmes JH, Balas EA, Boren SA. A guide for developing patient safety curricula for undergraduate medical education. Journal of the American Medical Informatics Association, 2002, 9 (Suppl. 1):S124–S127. 8. Halbach JL, Sullivan LL. Teaching medical students about medical errors and patient safety: evaluation of a required curriculum. Academic Medicine, 2005, 80:600–606. 9. Sandars J et al. Educating undergraduate medical students about patient safety: priority areas for curriculum development. Medical Teacher, 2007, 29:60–61. 10. Walton MM. Teaching patient safety to clinicians and medical students. The Clinical Teacher, 2007, 4:1–8. 11. Walton MM, Elliott SL. Improving safety and quality: how can education help? Medical Journal of Australia, 2006,184 (Suppl. 10):S60-S64. 12. Ladden MD et al. Educating interprofessional learners for quality, safety and systems improvement. Journal of Interprofessional Care, 2006, 20:497–505.

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