Bridgepoint Health (Bridgepoint) is taking an innovative and empowering approach to advance patient safety throughout their organization. Based on the Patient Safety Education Program – Canada (PSEP –Canada) train-the-trainer model and framework, Bridgepoint has developed a customized patient safety education program that is having a ripple effect and changing their patient safety culture.
Kate Wilkinson, Director of Quality and Patient Safety at Bridgepoint and a PSEP – Canada Master Facilitator, was instrumental in bringing the PSEP – Canada program to Bridgepoint. Kate, along with three facilitators, Steve Hall (Allied Health Education Specialist), Carla Gibson (Nurse Educator) and Zahir Hirji (Advanced Practice Nurse, Infection Control) customized the PSEP – Canada curriculum for Bridgepoint in order to make practical changes in attitudes, behaviours and knowledge around patient safety. “We needed to broaden our base of expertise; it could not just come from one individual,” says Wilkinson. “The PSEP – Canada model provided the opportunity to develop a broader group of individuals at the facilitator level and is structured so participants can become patient safety trainers.”
The inaugural Bridgepoint patient safety education program trained 40 staff; another 48 are currently going through the program. To take part in Bridgepoint’s program, there was an application process where participants outlined a work-specific project they would implement to advance patient safety and make a positive impact on patient care.
In developing a patient safety education program, Bridgepoint wanted to enhance the content to make it more meaningful for their participants. Tailoring the PSEP – Canada curriculum specific to their needs and interests involved a lot of time and commitment. However, incorporating Bridgepoint examples into the modules was a way to increase an understanding of what was in place and to help participants learn what was really important in terms of patient safety.
Each of the facilitators were assigned modules to develop, based on their interests. “We liked the fact that we could take the PSEP – Canada modules and instill our own flavour and a local spin on them,” says Gibson. “We made conscious decisions on what we wanted to deliver, what was important, how would it work, how to deliver and what tools to use,” adds Wilkinson. “We also created pre- and post- tests as a way to understand knowledge translation and evaluate the course from an outcome perspective.”
There was some innovative thinking within the group about labelling each session with a theme and connecting a safety aspect to it. For example, a Formula One racing theme was incorporated into a session on teamwork. “When we used distinct examples from our experiences for the case studies and role plays, it really brought home the message and “Bridgepointized” the content for the participants,” says Hall.
Four one-day sessions were developed; the sessions were designed to build on one another, not repeat content. The facilitators wanted to ensure that the sessions were interactive and relevant for the participants, and activities were frequently switched-up to keep learners engaged with the material. Each session was peppered with a good balance of role plays and case studies. “We developed the modules we would introduce over the four days; however, we re-jigged the content as we went along based on the feedback we received from each session and the needs of the learners,” says Wilkinson.
Prior to each session, participants were provided with a package that contained two or three relevant articles and these pre-course materials were used in the sessions to tie the content together. Understanding adult learning principles, the facilitators recognized that not everyone would read the articles, however some people like to have them ahead of time. By sending information out prior and using it during the sessions, the facilitators demonstrated the value of the pre-course material.
Each session was introduced with a plenary designed to get people’s attention, hold their attention for the rest of the day, and help participants to understand the real importance of the work that they are doing. “We kept the plenary short and focused less on the breadth of the content, but rather to really go for that shock and “ah” factor,” says Wilkinson.
Some of the modules were delivered using co-Facilitators, partnering to deliver the education. The facilitators say that this approach takes more time upfront to plan because you have to work together, rather than individually. “In a way, we were modelling interprofessional behaviours within our team and the sessions were much more dynamic with co-facilitation,” says Hall. “It is a lot for one person to deliver the content, facilitate and manage questions. This approach really worked well and we had a lot of fun working as a team. ”
The facilitators quickly recognized that the more interactive the sessions, the more people responded and participated. “When we went through the role plays we set up an environment that was safe, where people felt supported,” says Gibson. “They became engaged in the process and that is the biggest tell that you are doing something right.”
For some sessions, guest lecturers were brought in and paired up with the facilitators; some guest lecturers were from the audience and others were external. Having experts within your facility to speak about patient safety provides a refreshing opinion or view and gives variety to the lectures.
The facilitators reinforced that sending people to a course is not enough; to be effective you need leadership support and dedicated people in the organization who are good at facilitating and also have an interest in patient safety. Having work-based projects incorporated into the program helped them to keep in touch with the participants and provided much needed skills in problem-solving on the frontline.
All of the teams prepared poster boards on their projects and made presentations during clinical rounds. Two of the teams presented their projects to Board members and hospital executives. “It is not often when you have Board members engaged and asking questions of staff where there is a common theme of patient safety,” says Hall. “To sit back and watch that evolve was very rich and both sides learned from that interaction.”
“Participants learn a lot about how and what to do to improve patient safety in their practice and they now know what they would do differently in a situation when patient safety is compromised,” says Wilkinson. “The bottom line is that they now feel empowered to do something.”
In the spring of 2013, Bridgepoint will move to a new state-of-the art facility; the hospital will go from 10 to 14 units, the units are smaller and the teams will be changing. They are now looking at the training and education needs for every staff member to make the transition. With more teams and a different bed configuration there are many teamwork and communications challenges to address from a patient safety perspective. “We need to integrate patient safety education into that orientation and whether it is a standalone four-hour component, or integrated as a common theme that winds its way through the entire content is yet to be decided,” says Wilkinson. “Our goal is that each direct care staff member will have a core patient safety education program that will include teamwork and communications, technology and human factors, and systems-thinking.”
This is the first article in a three-part series on how Bridgepoint Health has customized the Patient Safety Education Program – Canada to advance patient safety in their organization. Click here to learn more about the participants and their work-based projects.