Transcript HERE for a powerpoint presentation

WORLD HEALTH ORGANIZATION
PATIENT SAFETY CURRICULUM GUIDE
MULTI-PROFESSIONAL EDITION
Contents:
1. Processes of WHO Curriculum Guide
2. Why Patient Safety Education? What
is the Curriculum? How to use it?
3. Principles and structure
4. Medical school curriculum, evaluation
5. Multi-professional curriculum
PATIENT SAFETY PROBLEM
“Human beings make mistakes
because the systems, tasks and
processes they work in are poorly
designed.”
Dr Lucian Leape, testifying to the US
President’s Commission on Consumer
Protection and Quality in Health
PATIENT SAFETY AND EDUCATION
'Patient safety is a core attitude and thus
needs to be introduced early and then
reinforced throughout postgraduate
education and continuing professional
development.'
Stefan Lindgren, President of the World Federation for
Medical Education
WHO PATIENT SAFETY AND EDUCATION
2008:
Patient Safety Education programme initiated
2009:
Launch of the Patient Safety Curriculum Guide for Medical Schools
2010
Evaluation of Curriculum Guide for Medical School in 12 pilot sites
(9 countries)
2010: Patient Safety Curriculum Guide: Multi-professional edition initiated
2010:
Regional experts and intl. foundations engaged
2011:
Completion of multi-professional edition (Spring)
2011:
Launch of the Patient Safety Curriculum Guide: Multi-professional
edition around the world
2011: Development of tools for introducing the curriculum in universities
2011- Development of courses/ e-courses based on patient safety
curriculum guide
WHY PATIENT SAFETY EDUCATION ?
 Modern healthcare comes with huge benefits but also many
risks
 Because of risks to patient safety, all health care providers,
managers, organizations, governments must become familiar
with quality and patient safety
 Patient safety education and training is limited
 Students must be trained to practice safe care, manage
challenges
 Patient safety education is not stand alone: it integrates in all
health care topics and education
 Teaching patient safety skills should begin in 1st year students
The Problem
Systemic
problems
•Mismatch of competencies to patient & population needs
•Poor teamwork
•Gender stratification of professional status
•Narrow technical focus without broader contextual understanding
•Episodic encounters
•Hospital orientation
•Weak leadership in health system performance
Professional
education
not kept pace
Today more
complex, costly
health care
Integrated modern science into curricula
at university based schools
WHY WAS THE CURRICULUM DEVELOPED?
 Patient safety education not kept up with workforce requirements
 Several factors impede patient safety education:
1. lack of recognition by educators that teaching patient
safety is essential and skill can be taught
2. educators not familiar with literature /how to integrate
patient safety into existing curricula
3. reluctance to address knowledge that originates from
outside one's profession (systems thinking and quality
improvement, patient safety methodologies)
4. attitudes of traditional teacher–student hierarchical
 Curriculum fills gap by: supporting educators to build foundation
knowledge and skills for all health care students and prepare them
for practice
WHAT IS THE CURRICULUM GUIDE ?
Comprehensive
programme for
educating in
patient safety
Part A:
Teachers Guide to
assist teachers
implement
curriculum guide and
building capacity in
patient safety
education
Part B:
Comprehensive,
ready to teach, topicbased patient safety
programme that can
be implemented as a
whole or per each
topic ( or module)
HOW TO USE THE CURRICULUM GUIDE
Introduce all curriculum topics/modules OR
one topic at a time. Each topic contains
technical information and instructions on
how to teach it.
Universities
and faculties
Suggestions about introducing case
studies are provided
The topics have been designed so that
students can be responsible for much of their
own learning (e.g reading on line materials)
Educators encouraged to add professional
literature and data on topics to teach.
PATIENT-CENTRED CARE REQUIRES:
New knowledge
& skills required
Partnerships with patients
& carers
Teamwork
Risk management/communication
Data collection
Adverse events
Professional responsibility
Professional accountability
Competent care providers
Deliver patient centred care
Active member of multidisciplinary
teams
Report and learn from errors
Apply evidenced-based health care
Ethical and safer practices
Use quality improvement and patient
safety approaches
Use information technology
AIMS: PATIENT SAFETY CURRICULUM GUIDE
Prepare students for safer practices in workplace
Inform universities/ faculties in patient safety topics
Provide comprehensive curriculum to assist teaching,
integrating patient safety learning
Develop capacity for patient safety educators
Strengthen patient safety education in universities/faculties
Raise international profile of patient safety and foster
international collaborations on patient safety education, research
WHO PATIENT SAFETY CURRICULUM GUIDE
Based on multi professional Australian Patient
Safety Education Framework
 Evidenced based
 Identify learning outcomes
 Build on what is currently taught
 Identify how patient safety could be integrated into current
programmes
WHO PATIENT SAFETY CURRICULUM GUIDE
Underpinning principles:
 Capacity-building is integral to curriculum change
 A flexible curriculum
 Easily understood language
 A guide for all countries, cultures and contexts
 A guide based on learning in a safe and supportive
environment
WHAT IS THE CURRICULUM GUIDE ?
Designed to build
capacity and
program planning
and design
Part A: Teachers
Guide to assist
teachers implement
curriculum guide and
building capacity in
patient safety
education
Comprehensive
programme for
educating in
patient safety
One stop
shop:
* Flexible
* Educators
can start it at
any stage
* Can apply
entire
curriculum or
Part
B:
selective
Comprehensive,
topics on case
casetopicbasis
ready to by
teach,
based patient safety
programme that can
be implemented as a
whole or per each
topic ( or module)
PART A: TEACHERS GUIDE
 Designed for faculty staff and
clinician teachers
 Provides a step by step tutorial
 Easily adaptable for other health
professionals
 Designed to assist, facilitate and
guide faculty in their approach to
patient safety education
CONTENT OF PART A: TEACHERS GUIDE
 How were topics selected
 Implementing the guide
 How to evaluate patient
safety curriculum
 How to integrate patient
safety into your curriculum
 Web based tools and
resources
 Educational principles
essential for patient safety
teaching & learning
 Activities to assist patient
safety understanding
 How to assess for
knowledge of patient safety
(students' testing)
 How to foster & engage
in a transnational
approach to patient
safety
WHO PATIENT SAFETY CURRICULUM
GUIDE: CULTURE CHANGE
AREA or ATTRIBUTE
EXAMPLES
OLD WAY
NEW WAY
Medical Hierarchies
Hand hygiene:
Doctor does not clean hands between
patients
Student says nothing and
conforms to inadequate
practices. Imitates senior
doctor.
(1) Seek clarification on the 'when and
how' for hand hygiene with the doctor
or other senior person.
(2) Say nothing but use safe
hand hygiene practices
(3) Say something in
respectful manner to the
doctor concerned and
continue to use safe hand
hygiene practices
Medical Hierarchies
Site of surgery
Surgeon does not
participate in checking the
correct site for surgery or
verifying the correct patient
The surgeon is resentful of
the pre-operative checking
protocol, believing it to be a
waste of time, and
pressures the rest of the
team to hurry-up.
Adopt the approach of the
surgeon and don’t
participate in checking –
decide that checking is too
menial a task for a doctor
anyway.
(1) Actively help the rest of
the team to complete the
checking protocol
PART B: TOPICS OF THE CURRICULUM
1. What is patient safety?
2. What is human factors
engineering?
3. Understanding systems
and the impact of
complexity on patient
care
4. Being an effective team
player
5. Understanding and
learning from errors
6. How to manage clinical
risk
7. Methods for quality
improvement
8. Engaging with patients
and carers
9. Minimising infection
through improved
Infection control
10. Reducing risks
associated with Invasive
procedures
11. Improving medication
safety
PART B: STRUCTURE OF EACH TOPIC
 Topic title
 Rationale
 Learning outcomes
- Knowledge requirements
- Performance requirements
 How to teach this topic
- Strategies & activities
- Tools & resources
 How to assess this topic
 How to evaluate the teaching session
WHO PATIENT SAFETY CURRICULUM GUIDE
FOR MEDICAL SCHOOLS: EVALUATION
 Nine countries ( 1
2 sites) worldwide
Argentina, USA, UK (Scotland), Israel,
Saudi Arabia, Nepal, India, Australia, Ethiopia
 Study led by University of Aberdeen, ended 2010
 Mixture of techniques ( quantitative and qualitative)

What is the impact of the teaching on students?

How usable is the WHO Patient Safety Guide?

Can this curriculum be used for widespread implementation of patient
safety education globally?
Evaluation of Patient Safety Curriculum Guide for Medical Schools
undertaken by University of Aberdeen
WHO PATIENT SAFETY CURRICULUM GUIDE FOR
MEDICAL SCHOOLS: MAIN EVAL. OUTCOMES
 WHO Curriculum Guide is highly valued with clear structures and
excellent content
 Recommendations to educators are particularly useful
 Most schools received unsolicited remarks from students on how
positive was to include patient safety. (Students reported medium to
nil levels knowledge of patient safety and med errors before initiations
of teaching)
 General agreement on all schools that teaching has been positively
received
 All schools included a minimum of 3 topics and 2 schools all 11
topics: Most taught topics: What is patient safety? Infection control, 2
schools took :'Human factors' topic
 All schools will continue to teach topics introduced, 5 schools plan for
introduction of new topics and 3 more to include all 11 topics; Some
schools plan introduction of new educators to teach patient safety
WHO PATIENT SAFETY CURRICULUM
GUIDE: MULTIPROFESSIONAL EDITION
 First wave focus on medical schools
 Widespread demand for broader second edition
 Recognition of common underlying principles
 Balance need for profession-specific material
 Inter-professional vs. segregated learning
WHO PATIENT SAFETY CURRICULUM
GUIDE: MULTIPROFESSIONAL EDITION
Working with international professional federations
■ World Dental Federation
■ International Confederation of Midwives
■ International Council of Nurses (including EFN)
■ International Pharmaceutical Federation
Working with student bodies
■ International Association of Dental Students
■ International Pharmaceutical Students Federation
■ International Council of Nurses Student Network
■ International Federation of Medical Students Associations
Patient Safety Curriculum Guide:
Expert Working Group Members
Regional Experts
Professor E. Acosta-Gio (OSAP and ADM):
School of Dentistry, National University of Mexico
(UNAM), Mexico, D. F., Mexico
Multi-Professional Experts
Professor M. Airaksinen (FIP): Faculty of
Pharmacy, University of Helsinki, Helsinki, Finland
Professor A. Crisostomo (West Pacific
Region): Department of Surgery, UPCM-PGH,
Manila, Philippine
Professor M. Barger (ICM): Department of Family
Health Care Nursing, University of California, San
Francisco, USA
Mr M.A. Hamandi (Eastern Mediterranean
Region): Makassed General Hospital, Beirut,
Lebanon
Professor J. Barry (ICN): Nursing and Health Policy,
International Council of Nurses, Geneva, Switzerland
Ms T. Nauiseb (African Region): Faculty of
Health & Medical Sciences, University of Namibia,
Windhoek, Namibia
Ms R. Sitompul (South East Asian Region):
School of Nursing, Universitas Pelita Harapan
(UPH), Jakarta, Indonesia
Professor J. Vlček (European Region):
Department of Social and Clinical Pharmacy,
Charles University, Heyrovskeho, Czech Republic
Mr S. M. Chittoory (IPSF): Massachusetts College
of Pharmacy and Health Sciences (MCPHS), Boston,
USA
Mrs M. Murphy (Patient Champion): Patients for
Patient Safety Programme, WHO PSP, Cork, Ireland
Dr J. Rohe (WMA): Agency for Quality in Medicine,
Berlin, Germany
Professor N. Yamalik (FDI): Department of
Periodontology, Hacettepe University, Ankara, Turkey
The WHO team
External Expert Lead: Prof. B.
Barraclough, Clinical Lead/Chair,
WHO Curriculum Working Group
Lead writer: Prof. M. Walton,
Sydney School of Public Health,
Faculty of Medicine, University of
Sydney, Sydney, Australia
Programme Manager:
Dr A. Leotsakos, World Health
Organization, Patient
Safety
Programme Consultant:
Dr B. Ellis
Programme Support: Ms C.
Nakandi, Dr H. Zheng,
World Health Organization,
Patient Safety
Download the Curriculum and teaching slides for free:
http://www.who.int/patientsafety/education/curriculum
National Patient Safety Education Framework Walton M, Shaw T,
Barnett S, Ross J Developing a National Patient Safety Education
Framework for Australian Quality and Safety in Health Care 2006 15:43742
What exactly is patient safety?
Emanuel L, Berwick D, Conway J, Combes J, Hatlie M, Leape L, Reason J,
Schyve P, Vincent C, Walton M. In: Henriksen K, Battles J B, Keyes M A,
Grady ML, eds. Advances in Patient Safety: New Directions and Alternative
Approaches. Rockville: Agency for Healthcare Research and Quality August
2008
WHO Patient Safety Curriculum Guide for Medical students
Walton M, Woodward H, Van Staalduinen S,Lemer C, Greaves F, Noble D,
Ellis B, Donaldson L, Barraclough B The World Health Organization (WHO)
Patient Safety Curriculum Guide for Medical Schools
( for submission)
THANK YOU
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