Teaching Health Care Providers to

Fish: Building Safety Competency

Abigail Hain RN, MScN, CNCC(c)

Director of Education

CPSI

ACADEMIC HEALTH EDUCATION

Building Quality Care from the Ground Up

BCPSQC, Vancouver, BC, 2013

System Complexity

CMPA

System Failures

Harm

From J. Reason

Funding &

Resources

Organization Culture

Incomplete

policies

Team Shifting

responsibilities

Handovers

Provider Training

Distractions

Fatigue

CMPA

Patient Safety

Human Aspect

Name – blame – shame – retrain

CMPA

Organizational Culture

Accreditation Canada

Safety Culture Survey

(2009)

No widely accepted approach to incorporate patient safety practices into the education of health professionals in Canada

The Safety Competencies framework provides a set of core domains of abilities for all health professionals to incorporate into their professional development

By enhancing the education of health professionals, the Safety Competencies will enhance patient care

Why Develop the Safety

Competencies?

Momentum

Key Competency Assumptions

• competent workforce has basic knowledge, skills, abilities and attitudes

for delivery of essential patient safety practices

• acquiring competencies can occur through formal training, experience,

performance support systems, and on-the-job training

• competency statements do not distinguish between academic or practice

settings

• no expectation of a single, uniform curriculum in formal academic

settings or organizations

• competency statements describe an acceptable level of performance,

the skill needed to perform the work, and the actual conditions under

which the work is executed daily

•

In Training In Practice

Standards of Practice

Desired Outcomes for:

CPD/CQI Programs

(educational and other outcomes)

Continuing Competency

Assessment

Entry to Practice/

Certification Exams

Educational Outcomes

Educational Outcomes for:

Residency

Internship

Undergraduate Program

Design of programs (curriculum, entry

requirements, assessment programs,

CPD, CQI, etc)

Ideal Practice

Competencies Detailed description of

ideal practice that is

futuristic and serves as a

vision for the profession Definition of what patients /

society require of

healthcare professional

What faculty want students

to be able to do upon

completion of the

educational program

(includes competencies

…and…

additional outcomes

Specific, measurable

competencies that are

critical to safe & effective

care Align educational outcomes

for sequential programs

required for licensure

Health Care Professions: Competencies

Patient Safety Framework

“No one health professional or provider can ensure safety independently. Patient safety can be advanced only through a team effort that addresses the various contributions of each member, the various aspects of the care processes, and the many transitions for any given patient in the system.”

Frank JR, Brien S, (Editors). Strategies for Implementing the Safety Competencies in the Health Professions, The Safety

Competencies: Enhancing Patient Safety Across the Health Professions. Ottawa, ON: Canadian Patient Safety Institute;

2008.

Guiding Principles

key knowledge, skills, and attitudes related to patient safety competencies

benchmark for training, educating and assessing

integration into curricula at educational institutions, PD programs of health care associations and directly into patient care sites

inter-professional and inter-organizational collaboration

easy for everyone to understand and apply

Development Process

Background work

Education and Professional Development Advisory Committee study session – October 2006

Environmental scan of HPE curricula in Canada

Literature review of patient safety curricula

Interprofessional Steering Committee

Initiative review and thematic analysis of themes • Identification of 7 Domains initially

Stakeholder consultation (>500 organizations)

Results

Comprehensive Interprofessional Patient Safety Framework

Competency-based approach

Simple and flexible

Designed for multiple health professions

By enhancing education, the framework can enhance patient care

Dissemination and Stakeholder Engagement

• In academia …

quicker uptake due to experience with competencies,

availability of health educators, formal mandate, etc.

• In practice …

challenges in translating competencies into learning

opportunities for staff, health professionals

– BUT…

– Great interest, buy-in and/or plans for adoption/integration

on most fronts – aiming for a “tipping point”?

e-Mapping Project

Safety Competencies overlap with the CIHC Competencies

Integration of interprofessional competencies is now strongly supported for undergraduate health professions programs by accrediting bodies

created linkages between the SC and CIHC Competencies – each CIHC competency is linked to one or more

relevant Safety Competencies

– as curriculum is mapped to the SC, the mapping to the CIHC competencies occurs in the background

e-Mapping Project

Nursing – CASN accreditation standards mapped

– Queen’s U. committed to mapping curriculum and their new Masters’ Program in HC Quality, Risk and Safety

– CNO regulatory requirements mapped

Pharmacy – software tested with Waterloo’s undergraduate curriculum

– Memorial Faculty of Pharmacy pilot underway

Medicine – mapping to CMPA’s Good Practices Guide complete

– pilot test underway with McMaster for Pediatric Chairs of Canada, including CanMEDS stream

– abstract submitted for CCME workshop – April 2013

Mapping Project – Profession

specific mapping

Mapping Project

CMPA – mapping to Good Practices Guide -

complete

Pharmacy – Waterloo complete, Memorial

pilot in progress

Nursing - CASN Accreditation Standards,

Queen’s pilot completed

Paediatric Chairs of Canada – McMaster pilot

October 2012 (today’s presentation!)

simulated learning experience:

Designed for pre-licensure (student, undergraduate) and post-licensure (practicing) healthcare professionals

Enhances effective communication and collaboration within healthcare teams including patients and their families to improve patient safety

“This program fills a gap and provides a solid foundation to help take patient safety education to the front-line,” says Kristi Chorney, Manager of Quality, Patient Safety and Risk, Brandon Regional Health Authority.

“This group was very energetic. There was excellent discussion about methods to advance from attitudes about patient safety into cultural change or the normal way of performing our work. We went away with a feeling that something good was going to happen in terms of being proactive rather than reactive in our approach to patient safety education.”

Healthcare teams attend

PSEP-Canada

Safety Culture

• Informed culture

• Reporting culture

• Just culture

• Improvement culture

• Learning Culture

Catch the

fish up stream

Questions?

Comments?