Academic Year 2020-21
The patient safety mini course is designed to provide residents with a broad instruction and practical skills required to become proficient and capable of leading others in reporting medical errors and analyzing patient safety events. The course focuses on four key areas which include; identification of medical errors, reporting medical errors, developing skills to conduct root cause analysis, and developing high-level action plans.
WHO SHOULD TAKE THIS COURSE?
This course is intended for medical residents and upper level medical students.
WHAT SHOULD I EXPECT
The course contains 4 lessons., Learners should view all content, read the assigned readings, complete all course activities, and pass the associated assessments. The course requires active participation in the discussion boards as well as once a week group meeting utilizing the Zoom platform.
INSTRUCTOR: ERIC M. ANDERSON, M.ED.
Mr. Eric Anderson is the Associate Designated Institutional Official and Director of Graduate Medical Education at Carolinas Medical Center in Charlotte, North Carolina. He has served as faculty and administration of medical residencies for over twenty years. He has also served as the executive director of a K-8 charter school and a middle school teacher. Mr. Anderson serves on the Alliance of Independent Academic Medical Centers annual meeting planning committee and serves on numerous local, regional, and national committees in the field of graduate medical education. Along with his colleagues Mr. Anderson has designed a several initiatives, workshops, and courses intended for medical residents and faculty.
ABOUT THIS COURSE
Welcome to Patient Safety 101: Unlocking the Cure. This course will provide you with the foundational knowledge of patient safety concepts. Participation in this course will help define not only patient safety concepts but also how they align to your own world view and how you care for your patients. Unlike many courses you have taken in medical school this course is based with biblical foundations that relate medicine to lessons we are taught throughout the Old and New Testament. Prior to beginning this course please review the Course Content section. This section will provide the content of the course and will help you plan your schedule and time commitment. In addition, please review the course materials as they will be utilized throughout the course.
The Patient Safety 101 course discusses the principles of patient safety from the AHRQ National Patient Safety Goals and threads in a biblical world view. Participation in the course will help the learner enhance their patient safety skills and help them define their own world view from a biblical foundation and how that enhances their patient safety skills.
Physicians can often feel isolated and when medical errors are made take on the blame to the point of hurting self. It is important that they know that the hand of God is with them and that they have others in the healthcare system that are there to help them through difficult times. Fear not, for I am with you; be not dismayed, for I am your God; I will strengthen you, I will help you, I will uphold you with my righteous right hand” (Isaiah 41:10, ESV). “Now these things happened to them as an example, but they were written down for our instruction, on whom the end of the ages has come” (1 Corinthians 10:11, ESV). We must learn from our mistakes and improve from them. Everything in life offers us lessons that we can learn from and share with others. This is the case in medical errors and near misses. We should open and allow others the opportunity to learn from this as well. “There is no fear in love, but perfect love casts out fear. For fear has to do with punishment, and whoever fears has not been perfected in love” (1 John 4:18, ESV). We cannot fear being cast out as a result of a mistake. For healthcare to have a just culture we must provide the love to each other that He expects from us. These verses embody the purpose of the patient safety course and help prepare the learner to provide safe, responsible care with a renewed compassion for all participants in the healthcare encounter.
Prevention education, not punishment will cure medical errors.
These lessons have several different elements that may include short readings, videos, quizzes, and discussion forums. This course is divided into the following four different lessons.
Lesson 1: Patient Safety 101
Lesson 2: Error Prevention Skills
Lesson 3: Error Scene Investigator
Lesson 4: Detailing the Path Forward to Improved Outcomes
GLOSSARY OF TERMS
Patient safety is a discipline in the health care professions that applies safety science methods toward the goal of achieving a trustworthy system of health care delivery (Patient Safety and Quality Improvement).
Medical error is an unintended act, either of omission or commission, or an act that does not achieve its intended outcome." 2. Sentinel Event: "An unexpected occurrence involving death or serious physical or psychological injury or the risk thereof (Patient Safety and Quality Improvement).
Near miss is an event or a situation that did not produce patient harm because it did not reach the patient, either due to chance or to capture before reaching the patient; or if it did reach the patient, due to robustness of the patient or to timely intervention (Patient Safety and Quality Improvement).
Root cause analysis is a problem-solving method which is used to pinpoint the exact cause of a problem or event. The root cause is the actual cause of a specific problem or set of problems, and when that cause is removed, it prevents the final undesirable effect from occurring (Patient Safety and Quality Improvement).
I am here to help you in any way I can. Do not hesitate to reach out to me if you have questions or concerns. The best way to contact me is via email:
Each lesson in the Patient Safety 101 course contains a discussion forum where learners can engage with each other in reflection and dialogue regarding the ideas and strategies presented in the lesson. Please note that you are required to complete one original post as well as add two substantive responses to your colearners within each forum. The original post should be 500 words and cite appropriate references. Relies should be a minimum of 250 words and provide how you agree or disagree with the discussion and recommendations. All posts should use relevant scholarly sources and scripture to support your claims.
Lesson 1: Why are the national patient safety goals essential for medical residents to understand? How does your biblical world view enhance how you understand the national patient safety goals?
Lesson 2: Medical errors happen every day in the United States. How does the bible inform us of understanding our mistakes and taking responsibility for them? How can we apply the lessons learned from our error to improve future patient outcomes?
Lesson 3: Why is it important to have a review of a medical error event? Why is looking at system factors important to preventing future medical errors? Provide a lesson learned form the Bible where a system factor was addressed.
Lesson 4: We heard about how the path forward to minimizing and potentially eliminating some medical errors is through the development of a culture of safety. Describe how you would promote a culture of safety and ensure that individuals were comfortable in reporting medical errors and near misses?
Lesson 1: Website: How to Use Data to Improve Quality and Patient Safety (https://www.healthcatalyst.com/insights/use-data-improve-patient-safety/)
Lesson 2: Madani, A., Vassiliou, M., Watanabe, Y., Al-Halabi, B., Al-Rowais, M., Deckelbaum, D., Fried, G., & Feldman, L. (2017). What Are the Principles That Guide Behaviors in the Operating Room? Annals of Surgery: a Monthly Review of Surgical Science and Practice, 265(2), 255–267.
Lesson 3: Richter, J., & Melendez, B. (2017). Getting to the root of the problem: with a clear understanding of root cause analysis, medical device manufacturers will be equipped with a prescriptive approach to problem-solving. Medical Product Outsourcing., 15(3).
Lesson 4: Morello, R.T., Lowthian, J.A., Barker, A.L. (2013). Strategies for improving patient safety culture in hospitals: a systematic review. BMJ Quality & Safety. 22(1):11-18.
Q: Who should take this course?
A: Anyone medical resident wanting to improve the outcomes of patients and positively impact the rate of medical errors and near misses in the US healthcare system.
Q: How long is the course?
A: This is a 4-week course where you will do 4 modules each week that include videos, readings, quizzed, and discussion boards.
Q: What will this course offer me that I could not simply learn on my own?
A: This course will provide you with the ability to apply the knowledge obtained immediately to your daily work with patients. It will also provide you with the opportunity to serve on case analysis that may make system-wide changes.
Q: What do I get to provide evidence of my training from this course?
A: Upon successful completion of the course the learner will be provided a certificate that demonstrates the course completion and skills learned.