Patient safety in an interprofessional learning environment

Context and setting The Faculty of Medical and Health Sciences at the University of Auckland developed a shared learning programme on patient safety and quality improvement in health care for its undergraduate medical, nursing and pharmacy students. Why the idea was necessary Traditional undergraduate education of medical, nursing and pharmacy students seldom provides the opportunity for students to practise working in interprofessional teams. Interprofessional learning is defined as a process by which 2 or more professions learn from and about each other in order to improve collaboration and the quality of care. Its goals are the development of adaptable, flexible and collaborative teamworkers. Teamwork implies recognition by each health care worker of the strengths that other professions bring to the clinical team, respect for other members of the team and sufficient trust to allow open discussion within the team and the translation of this discussion into action. The importance of teaching students about patient safety has recently become apparent from highly publicised adverse health care events. Patient safety depends upon teamwork and thus was seen as an ideal topic for interprofessional education. What was done All Year 3 students (∼ 300) participated in a learning experience over 2 days. One goal was that the students should understand the concept of quality improvement through recognition of the underlying failures in the system that can lead to individual error. This was achieved using ‘root cause analysis’ as a tool to analyse adverse events and explore the actions a health care team might take to prevent their recurrence. The second goal was to provide an opportunity for interprofessional learning across the different programmes. Students were introduced to the theoretical elements of quality improvement and root cause analysis. The model of root cause analysis developed by the US Veterans Affairs Department was presented using the real-life (non-medical) example of a major plane crash in Antarctica. Students working in interprofessional small groups (10–12 students) then undertook root cause analyses of clinical scenarios (based on actual clinical cases) in which adverse events had occurred. A teacher presented each step of the analytical process before the students broke into small groups to apply this knowledge to their cases. Representatives of the 3 professions, as well as hospital quality managers, facilitated the group work. The groups presented their analyses to panels led by the heads of the participating schools (medicine, nursing and pharmacy). Evaluation of results and impact A formative evaluation assessed the course from the perspective of the students. Students were asked to rate the course on a 12-item, 5-point Likert scale, where 5 = the most positive rating. Overall, students felt the experience deepened their understanding of quality improvement, enhanced their understanding of health problems, encouraged their understanding of other health professions and helped develop teamwork skills (x = 3.7). Facilitators also provided feedback on the course. Patient safety (with an emphasis on a systems approach to quality improvement) was affirmed as an appropriate topic for interprofessional learning, and the collaboration between academic teachers and clinical staff in this programme was thought to represent an excellent role model for interprofessional teamwork.