When giving introductory talks at both The Ottawa Hospital and the University of Ottawa, Dr. Sherissa Microys is often amazed at how her students will think that patient safety is just about preventing harm. “They have a narrow scope and don’t know that patient safety is much larger, incorporating a number of things like human factors, how we communicate, body language and disclosure,” says Dr. Microys. She uses the six puzzle piece image that make up the Safety Competencies framework so that her students can see what plays a part in patient safety and where it all fits in the bigger plan.
Dr. Microys says that the Canadian Patient Safety Institute Safety Competencies framework has been a tremendous help in advancing patient safety education. “The framework provides a consistent language, a consistent way to teach and to refer to,” says Dr. Microys.
The Ottawa Hospital is using the Safety Competencies as the platform for their patient safety program that includes modules focusing on each of the six domains. A multi-disciplinary working group that included physicians, nurses, pharmacists and administrators developed education modules around the skills, attitudes and knowledge described by the Safety Competencies. The patient safety training program is available as an online self-learning tool within the organization’s Enterprise Learning Management system. The patient safety training program is available as an online learning tool within the organization’s Enterprise Learning Management system. There are four streams available, targeted to job roles – clinical staff, non-clinical staff, administrative leaders, and clinical leaders.
A mass auto-enrollment was rolled out hospital-wide in May 2013, asking staff to complete the six modules within six months. To date, approximately 4,600 have completed their training, representing about 40 per cent of those enrolled. Follow-up is now underway with those individuals who have not yet completed all modules. This comprehensive program will continue to be used for new employee orientation and an optional refresher program is being developed for all staff. An evaluation of the patient safety education program will also be done next year.
A second component was added to the patient safety training program on how to use the Hospital’s online incident reporting system. The incident reporting system was underused and with this exposure, increased use of the reporting system has been an added benefit.
“The patient safety education program reinforces that everyone has a part in patient safety,” says Elena Pascuet, Patient Safety Coordinator. “We have moved the bar on our patient safety culture. With education, awareness and engagement we can all contribute to safer care.”
The Ottawa Hospital has implemented a number of platforms to focus on patient safety. An email address has been set up where staff can ask patient safety questions. Elena Pascuet says that staff are really getting engaged and stepping forward in terms of being aware of their surroundings and being able to identify risks. A monthly patient safety newsletter is dedicated to what is new and upcoming in patient safety and highlighting initiatives, and sent to all leaders and physicians for them to circulate to their teams. And, they continue to work on the patient safety education program. Pascuet says there is a lot more to come.
Focusing on patient safety education, Dr. Microys has at least 20 individual projects on the go all of the time, specific to all levels – medical students, residents, staff physicians, inter-professional groups, and unit-based and profession-based teaching. “We are looking at a lot of different strategies to find out what really works and trying to help sectors that are really struggling with this,” says Dr. Microys. “We need to try things out and have those lessons learned that we can share with one another.”
Dr. Microys is also on the faculty of the Advancing Safety for Patients in Residency Education (ASPIRE) program to accelerate patient safety teaching at a post-Graduate level and an advisor on the CanMeds 2015 Framework to incorporate the Safety Competencies into the milestones expected of students and trained physicians in Canada. “I get energized when I get together with like-minded people to advance patient safety,” says Dr. Microys. “We have a long road ahead and we need to encourage each other that this is valuable work and not to give up.”
Dr. Microys describes a safety culture as the way you do things around here that is naturally engrained. She says that they are starting to see that happening now, but there is still a long way to go to eliminate errors from happening. However, people are more attuned to patient safety and talking about it much more.
It has been said that you cannot change culture by one person alone; culture change takes a generation. “The next generation coming through is the one that will have received the education that will catapult healthcare into a safety zone,” says Dr. Microys.