1. WHO Global Patient Safety Consultation. Dr
WHO Global Patient Safety Consultation Dr. Jorge César Martínez Emeritus Professor Institute of Safety and Quality in Health Sciences del Salvador University Buenos Aires - Argentina

2. TRAINING THE NEXT GENERATION
PATIENT SAFETY CURRICULUM GUIDE MULTI-PROFESSIONAL EDITION 2

3. First global release in November 2011
WHO PATIENT SAFETY
CURRICULUM GUIDE 3

5. Why do we need education in patient safety?
Fundamental patient safety practices are far from universally applied in health care delivery
Current education in patient safety is fragmented and segregated
Governance and accountability for education is complex and ill-defined
There are few, if any, examples of comprehensive sustainable education programs

6. CHALLENGES: PATIENT SAFETY EDUCATION1
General:
Overcrowded curricula
PS not integrated into curricula & provides significant challenge
Mismatch: HCP knowledge to PS competencies + skills
Educators:
Not all educators have knowledge/capacity to teach PS
Educators are not familiar with the literature and unsure how to integrate patient safety in curricula
Unsure how to teach PS 2 3
Teachings:
- Poor teamwork because no inter-disciplinary training
- Gender stratification of professional groups + status
Narrow clinical training without and understanding on safety
Where there is, ps education to senior students / not early years. 6

8. PILOT STUDY FOR WHO PATIENT SAFETY CURRICULUM GUIDE FOR MEDICAL SCHOOLS
School of Medicine, del Salvador University, Buenos Aires, Argentina
Sydney Medical School, Australia
Maulana Azad Medical College, New Delhi, India
Sackler Faculty of Medicine, Tel-Aviv University, Israel
Patan Academy of Health Science, Kathmandu, Nepal
College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
Faculty of Medicine, University of Manitoba, Winnipeg, Canada
University of Aberdeen Medical School, United Kingdom
School of Medicine, Cardiff University, United Kingdom

9. WHO Patient Safety Curriculum Guide
for Medical Schools PROPOSAL GOALS - PHILOSOPHY
Key aims:
To prepare medical students for safe practice in the workforce
To inform medical schools of the key topics in patient safety
To enhance patient safety as a theme throughout the medical curriculum
To provide a comprehensive curriculum to assist teaching and integrating patient safety learning
To further develop capacity for patient safety educators in medical schools
Promote moving beyond blame (adverse events).
Safety culture instead of blame culture.

10. TOPICS INCLUDED Topic 1: What is Patient Safety
Concepts highlighted
Why it’s so relevant.
Patient Safety does not involve financial resources only rather they involve professionals’ commitment to practice Safety.
Teaching strategies:
Introduction during Educational Lectures
An interactive /didactic session using video clip of speeches that have been made by patient safety leaders.
At the Hospital: Spend a day with another health professional (nurse) identifying the main role and functions.

11. Topic 2: Apply human factors thinking to the work environment Concepts to be highlighted
Concepts highlighted
To understand the main role of human beings relationship between them and with the System.
Teaching strategies:
1) Introduction during Educational Lectures using interaction and discussion case study
2) Practical exercises on good and bad examples of human factors principles. Intensive Care Unit- Delivery Room. Out patient-Department.

12. Topic 3: Understanding Systems
Concepts highlighted
Changing the Doctor’s focus about risk from side effect and complications only
to apply the same reasoning to the treatment being provided by the people and the system.
What is high reliability organization.
Teaching strategies:
Lecture on System and Complexity (Introduction).
Follow a Patient from the time they enter the service to the time they are discharged. (From the System point of view).

13. Topic 4: Being an effective team player
Concepts highlighted
The challenge is not whether we will deliver care in teams but rather how well we will deliver care in teams.
Understand what is it to be an effective team player
Include the patient in the TEAM
GOOD COMMUNICATION as the main tool.
Teaching strategies:
Introduction during Educational Lectures
Participate in a Perinatal Care Team discussion.
Chronic patient follow up team meeting at the Maternity Hospital (interprofessional participation).
Reflective exercises at the last week.

14. Topic 5: Understanding and learning from errors
Topic 5: Understanding and learning from errors. Concepts to be highlighted
Concepts highlighted
Errors occur by doing the wrong thing or by failing to do the right thing.
Learn from errors
Tips to limit potential errors. Individual factors and situations (fatigue-stress-language-illness- attitudes, etc.)
What is a root cause analysis
Teaching strategies:
- Introduction during Educational Lectures
Interactive/Didactic lecture based on case study.
Group Discussion based on Students Journal about observed error and recommendations.

15. Topic 6: Understanding and managing clinical risk
Topic 6: Understanding and managing clinical risk. Concepts to be highlighted
Concepts highlighted
The role of complaints in improving care
Principles of risk management programs to reduce adverse events and improve human performance.
The educational discussion instead of attributing blame
Teaching strategies:
Introduction during Educational Lectures
Interactive/Didactic using case study.

16. Topic 7: Introduction to quality improvement methods
Concepts highlighted
The problems in health system are affected by the process of care and involve people who are treating and caring for patients that are not considered by evidence base medicine and randomized control trials.
What is Science of improvement
All quality improvement methods rely on measurement.
Teaching strategies:
Introduction during Educational Lectures
Interactive/Didactic Lecture

17. Topic 8: Engaging with patients and carers
Concepts highlighted
Understanding doctor-patient communication techniques and what a patient should know about his/her care.
Teaching strategies:
Introduction during Educational Lectures
An Interactive/Didactic lecture case study
Write a letter of apology related one case study or real experience.
Follow a Patient from the time they enter the service to the time they are discharged. (From the patient point of view).

18. Topic 9: Minimizing infection through improved infection control
Concepts highlighted
Clean hands are safer hands
Main causes and types of infections
Practice universal precautions
Teaching strategies:
Introduction during Educational Lectures
Interactive/Didactic lecture
Exercises: While allocated to a clinical environment.

19. Topic 10: Patient Safety and innovative procedures
Concepts highlighted
The main causes of adverse events in surgical care
The transcendental role of the guidelines protocols and communication
Teaching strategies:
Introduction during Educational Lectures
Interactive/Didactic lecture using a case study
Practical exercises while students are assigned to a surgical ward
Observe and record the activities undertaken and then a small group discussion take place.

20. Topic 11: Improving medication safety
Concepts highlighted
Why this issue is so important
The main steps in using medication
Sources of error.
Teaching strategies:
Introduction during Educational Lectures
Practical Workshops: prescribing and doing calculation
Interview a nurse- interview a doctor. Work related tasks in the clinical environment.

21. Concepts specially highlighted
How to face the old culture without confronting but in a mindfully way.
Incorporate the concept to practice safe health care even when those around them do not.
Understand Swiss Cheese Model to explain how faults in the different layers of the System can lead to accidents-mistakes-adverse events.
Being an effective team member means learning how to substitute roles and appreciate others perspectives
Relationship with patients implies relate and communicate with them as a unique human being.

22. CURRICULUM DELIVER Lectures On line activities
Clinical placement (beside the bed)
Round session (problem base learning)
On the ward activities

23. INTER-DISCIPLINARY TRAINING
Multi-professional perspective
Encourages inter-disciplinary learning
Suggests ways for joint learning
Prepares students and hc providers on being team members and effective clinical communication
Recommends on how to operate in a culture of no-blame but being accountable
Use case studies from multi-professional teams as a tool for interdisciplinary learning 23

24. How to approach patient safety teaching
Use a range of teaching methods: integration into curriculum
PBL
Simulated based learning ( low & high fidelity)
Lecture based teaching (interactive/didactic)
Mentoring and coaching
Student initiated learning (prescribed ward activities)
Small group discussion
On line learning

25. Enhancing medical training through simulation

26. What knowledge, skills and behaviours are necessary for safe practice?
Q 1
What knowledge, skills and behaviours are necessary for safe practice? 26

27. New knowledge & skills required Competent clinicians
Patient centred care
Deliver patient centred care
Active member of multidisciplinary
teams
Report and learn from errors
Apply evidenced based health care
Ethical practice
Use quality improvement approaches
Use information technology
Partnerships with patients
& carers
Teamwork
Risk communication
Data collection
Adverse events
Professional responsibility
Professional accountability

28. WHO Patient Safety Curriculum Guide Contents of Part A: Teacher’s Guide
Rationale for the topics
Aims of the guide
Implementing the guide
How to integrate patient safety into your curriculum
Educational principles essential for patient safety teaching & learning
How to assess patient safety
How to evaluate patient safety curriculum
Web based tools and resources
Activities to assist patient safety understanding
How to foster & engage in a transnational approach to patient safety

29. WHO Patient Safety Curriculum Guide Part B: The Topics in the curriculum
What is patient safety?
What is human factors engineering?
Understanding systems and the impact of complexity on patient care
Being an effective team player
Understanding and learning from errors
How to manage clinical risk
Methods for quality improvement
Engaging with patients and carers
Minimising infection through improved Infection control
Reducing risks associated with Invasive procedures
Improving medication safety

30. How is curriculum delivered?
Lectures
Clinical placements
Online activities
On the ward activities
Small group tutorial teaching
Problem-based learning ( PBL)
Simulation learning/skill laboratories 30

31. EVALUATION- CONCLUSIONS
WHO Patient Safety Curriculum Guide can support the introduction of patient safety teaching
local examples should be used to illustrate patient safety teaching
Should be highlighted the conditions and time required to successfully introduce patient safety teaching
Students improved knowledge of patient safety issues
Attitudes and Intentions become more positive.
The longer term outcomes in the healthcare workplace are required to be known and shared.