Patient Safety Instruction in US Health Professions Education

By Kiersma, Mary E.; Plake, Kimberly S. et al. | American Journal of Pharmaceutical Education, October 2011 | Go to article overview

Patient Safety Instruction in US Health Professions Education


Kiersma, Mary E., Plake, Kimberly S., Darbishire, Patricia L., American Journal of Pharmaceutical Education


INTRODUCTION

Approximately 98,000 people die each year in US hospitals from preventable medical errors, and these errors cost $30 billion in lost income and increased health expenditures. (1) The impact of these errors has led hospitals and regulatory agencies to focus on reducing the number of deaths and adverse events attributed to unintended and preventable medical errors. (1-3) In To Err Is Human: Building a Safer Health System, the Institute of Medicine (IOM) called for reevaluation of health professions education and the incorporation of patient safety into the curriculums of all health professions. (1)

In Crossing the Quality Chasm, the Institute of Medicine emphasized the need for healthcare professional educators to create new approaches in developing patient safety and quality improvement skills in their students. (4) In a follow-up report, Health Professions Education: A Bridge to Quality, the IOM clarified their vision, recommending that "all health professionals should be educated to deliver patient-centered care as members of an interdisciplinary team, emphasizing evidence-based practice, quality improvement approaches, and informatics." (5-6)

In light of this recommendation, educators should consider the development of a revised set of competencies for health professions' curriculums. (5,7) Health professionals, using scientific evidence, should be able to describe the components of patient-centered care, identify deviations from patient-centered care in their practices, and determine what actions should be initiated, if necessary, to correct those deviations. (8) Educators in medicine, nursing, and other health professions are challenged to develop learning experiences that provide the foundation for professional identity and enable graduates to deliver patient-centered care as members of an interdisciplinary team while emphasizing evidence-based practice, quality improvement approaches, and informatics. (4) Schools of nursing are addressing patient safety education through the Quality and Safety Education for Nurses initiative. (9) Additionally, the Accreditation Council for Pharmacy Education (ACPE) strongly encourages the addition of quality improvement education to pharmacy curricula. (10)

Although patient safety has been acknowledged as necessary in the provision of quality patient-centered care, few studies have been published that describe the design, implementation, and assessment of patient safety education. Describing the state of patient safety education in the health professions would provide educators with additional resources to develop patient safety initiatives. The purpose of this article was to describe research conducted on patient safety instruction in the health professions in order to inform health professions educators of ways to incorporate this type of instruction in their curricula.

METHODS

A search of the following databases was conducted for articles published between 1966 and December 2010: PubMed, Cochrane, MEDLINE, ERIC, Academic Search Premier, and ISI Web of Science. The following MeSH terms were used: "safety management" or "patient safety" and "education, dental" or "education, medical" or "education, nursing" or "education, pharmacy" and "curriculum." Only articles that described patient safety education in US health professions curriculum (medicine, nursing, pharmacy, and/or dentistry) were included.

One hundred fifty-four articles were identified and the abstracts evaluated for inclusion and exclusion criteria. Studies that were not about curriculum (30 articles) or patient safety (31 articles), or were not in English (3 articles) were excluded. Articles that focused on curriculums outside the United States (50 articles), as well as editorials, letters to the editor, and commentaries (12 articles), also were excluded. Also, 2 continuing education articles and 3 articles pertaining to other health-related professions were eliminated. …

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