Rotation Goals

The resident or fellow rotating on patient safety will gain expertise in healthcare quality improvement and simulation education as applied to patient safety. The experience is designed to educate the next generation of quality improvement innovators and patient safety leaders.

Rotation Competency-Based Objectives

Patient Care = System Care

With the system as the 'patient,' the resident/fellow leads and influences patient care delivery quality and safety by the following:

• Identifies instances of national patient safety goal non-compliance
• Identifies hazards/risks and opportunities for unsafe inpatient care through tracers and mapping of key patient care processes in inpatient setting
• Identifies hazards/risks and opportunities for unsafe care outpatient care through tracers and mapping of key patient care processes in outpatient setting
• Actively participates in hospital committees and safety initiatives
• Identifies and demonstrates critical actions that contribute to error reduction and patient safety

Medical Knowledge

• Discusses modern theory and principles of safety—for healthcare and non-healthcare industries
• Discusses impact of human factors on safety
• Describes and discusses the national patient safety goals and practical applications of each
• Describes and discusses strategies for system safety assessment
• Describes clinical and administrative indicators of safety and safe delivery of high-quality care
• Describes and discusses performance improvement methodology as applied to improving patient safety
• Demonstrates ability to analyze process and outcomes measures, data and impact on quality and safety

Interaction and Communication Skills

• Demonstrates the ability to communicate effectively with all members of a multidisciplinary team to gain buy-in and build consensus for system improvement
• Informs caregivers of feedback on safety measures and results of cycles of change
• Facilitates safety training for other providers through organizing and structuring safe patient care training scenarios for simulation
• Debriefs effectively following safety simulation education and demonstrates debriefing training for faculty and education leaders

Professionalism

• Demonstrates humanism and compassion to patients, families and team
• Demonstrates effective leadership in quality and safety, including constructively confronting and engaging of all types of providers in unsafe, low-quality, high-cost behaviors
• Demonstrates professional conduct through debriefing on appropriate and inappropriate behavior
• Exercises motivational techniques and facilitates learning of positive behavior change

Practice-Based Learning and Improvement

• Identifies resources for assessing quality and safety, especially as applied in one’s own practice
• Demonstrating within one’s own specialty the ability to self-assess practice patterns that contribute to quality and safety
• Identifies gaps in practice patterns relative to the evidence in safety and safety strategies
• Develops a performance improvement process and follow-up to show improvement

Systems-Based Practice

With the system of care as the focus for patient safety, the resident/fellow:

• Conducts system assessment through critical observation of patient experience and process tracer
• Identifies system errors and opportunities for system safety improvement
• Identifies and develops strategies for safety improvement
• Builds a multidisciplinary team approach to improving quality and safety through a safety (improvement) initiative that impacts safety measures
• Conducts cost-effectiveness analysis of safety and safety improvement initiatives (return on investment)
• Develops a value compass of balanced measures for safety initiatives

Fellowship Goals and Objectives

Goals

The patient safety fellow will gain expertise in healthcare quality improvement and simulation education as applied to patient safety. The fellowship is designed to educate the next generation of quality improvement innovators and patient safety leaders.

The health system is the patient - key elements for the fellow are daily rounds and regular updates on the system, including the “vital signs” of health and function.

Competency-Based Objectives

Patient care - with the system as the patient - a patient safety fellow identifies instances of national patient safety goal non-compliance, describes clinical and administrative indicators of quality and safety and actively participates in hospital committees and initiatives to lead and influence patient care delivery quality and safety. The patient safety fellow demonstrates humanism and compassion and facilitates other providers through organizing and structuring safe patient care training scenarios for simulation.

The patient safety fellow builds his/her medical knowledge of the national patient safety goals and performance improvement methodology. Moreover, the fellow demonstrates ability to analyze process and outcomes measures, data and impact on quality and safety, developing a value compass with balanced measures for quality improvement initiatives. Because of the growing role that simulation training plays in both education and safety, the fellow acquires expertise in the state of evidence in the simulation literature.

It is paramount that a patient safety fellow demonstrates the ability to communicate effectively with all members of a multidisciplinary team to gain buy-in and build consensus for system improvement, as well as inform caregivers of feedback on results of cycles of change. An additional aspect of interaction and communication skills provided in this fellowship is the ability to debrief effectively following simulation education and demonstrate debriefing training for faculty and education leaders.

Professionalism is inexorably linked to leadership in quality and safety and includes the professional conduct required for confronting and engaging all types of providers in unsafe, low-quality, high-cost behaviors. Simulation scenarios are important tools for demonstrating professional manner through debriefing on inappropriate behavior and to enable and facilitate learning of positive behavior change.

The patient safety fellow identifies resources for assessing practice-based learning and improvement in quality and safety, demonstrating within one’s own specialty the ability to self-assess quality and safety. The fellow develops a performance improvement process and follow-up to show improvement, identifying gaps in the evidence in simulation literature on education impact and identifying ways in which simulation may be appropriately applied.

With the system of care as the focus for the patient safety fellow, s/he identifies system areas of impact on safety, including system errors and works on strategies for system assessment and improvement. Systems-based practice involves building a multidisciplinary team approach to improving quality and safety through a performance improvement initiative that impacts safety measures, while demonstrating cost-effectiveness analysis of performance improvement initiatives (return on investment).