More than a decade ago, an Institute of Medicine study revealed that preventable medical errors were a leading cause of death, accounting for more fatalities than breast cancer, traffic accidents or AIDS in the United States. Today, the problem of medical errors remains and might even have escalated.
In the December 2012 issue of the journal Health Affairs, researchers at the University of Missouri and five other universities describe how medical and nursing schools could join forces to prevent potentially deadly errors. Their findings, which call for integrating interprofessional teamwork and quality improvement training into required curricula, are part of the Retooling for Quality and Safety initiative. Spearheaded by the Institute for Healthcare Improvement (IHI), its Open School, and Josiah Macy Jr. Foundation, the initiative conducted a far-reaching study involving nearly 1,400 student encounters.
"Interprofessional teamwork is crucial to developing more cost effective, patient-centered health care systems in the U.S. and around the world. If we expect physicians, nurses and pharmacists to implement new ways of working, we need to find innovative ways for students who'll be entering these professions to train together," said Maureen Bisognano, IHI president and CEO and an Institute of Medicine member. "The six universities who took part in Retooling for Quality and Safety have laid a strong foundation that others can learn from and build on in creating their own programs. Whether it's with grand rounds, simulation or improved communication skills, patient care has become a shared responsibility, and the sooner students experience this, the more prepared they'll be."
Most medical schools train students in quality improvement and patient safety, but most are not doing it with students from other professions. A review of medical schools showed that while 62 percent of them teach quality and safety, only 41 percent provide interprofessional education.
"Education in the health professions must prepare all students for working together toward a safer and better health care system," said Linda Headrick, MD, lead author of the article and senior associate dean for education at the University of Missouri School of Medicine. "The initiative showed us that medical and nursing schools can and should create learning experiences together and integrate that content into existing curricula. Now, we must spread the lessons learned from our research to all medical educators."
Headrick led the Retooling for Quality and Safety initiative. In addition to the University of Missouri, other participants included Johns Hopkins University School of Medicine, Penn State College of Medicine, School of Medicine at the University of Texas San Antonio Health Science Center, University of Colorado Denver School of Medicine, and Case Western Reserve University School of Medicine. Each participant has both a school of nursing and a school of medicine that worked together to develop and implement innovative methods to integrate health care improvement and patient safety content into existing required curricula. They used faculty development sessions, online training, small-group exercises in a classroom, and simulation laboratories.