Patient safety: an educational competency

Abstract

Although patient safety is of utmost importance in health-care encounters in all countries, preventable instances of harm are common. Crucial to increasing safety are safety cultures, atmospheres of error reporting, teamwork, and communication across roles and levels of authority that allow implementation of established safe procedures as well as innovation. Poor safety cultures are associated with increased error rates, yet surveys of safety attitudes among medical staff indicate that changes are often impeded by existing cultures of individual blame and attitudinal variations in specifi c care roles. Both punitive, blame-focused environments and divergent safety attitudes among care providers discourage the dialogue and teamwork crucial to systems level changes that increase safety. While continued eff orts to improve safety culture among staff are important, lasting change will only occur by engaging with trainees, the future providers who have hitherto largely been excluded from assessments. In a recent study, Hanan Aboumatar and colleagues found that curricular eff orts aimed at improved patient safety could improve trainees’ teamwork and communication skills. These promising fi ndings, how ever, have several limitations. First, the 3-day curriculum refl ects wide variations in quality, depth, and content among existing curricula, and highlights the diffi culty in interpreting overall effi cacy. Second, the intervention was too brief to address previous fi ndings that safety awareness among trainees is not always uniform and might not translate into appropriate safety behaviours. Finally, despite recognition of the need for interdisciplinary education, the study exclusively targeted medical students rather than students in other health-care professions. It is an important reminder that cadres of safety-minded providers will be cultivated only through robust curricula paired with comprehensive induction of teams into strong safety cultures. Nonetheless, the eff ort is crucial if the medical community is to champion patient safety in the future. Acculturation must begin early in undergraduate medical education and include interactions with other healthcare professions. To combat existing negative infl uences and connect safety awareness with corresponding behav iours, it must be sustained longitudinally through clinical experiences and careers through mechanisms like certifi cation and continuing medical education. Uncom promising focus on teamwork, communication, and safety is required—the professional integrity of generations of health-care professionals, and the patient safety agenda they are to be charged with, depend on it.