Interdisciplinary Patient Safety Certificate Program Prepares Health Professionals to be Effective Patient Safety Champions

Sunday, 26 July 2015: 3:47 PM

Lori Paine, MS, BSN, RN
Armstrong Institute for Patient Safety and Quality, The Johns Hopkins Hospital, Baltimore, MD

Background: Effective patient safety leadership requires more than a passion for preventing harm.  To thrive in this role, health professionals need a robust set of knowledge and tools to improve culture, effect behavior change, and fix broken care delivery systems.  The purpose of this paper is to describe a Patient Safety Certificate Program that has been developed to prepare health professionals to be effective patient safety champions and summarize program evaluation data.


Patient Safety Certificate Program: The Patient Safety Certificate Program was developed by experts from the Armstrong Institute for Patient Safety and Quality who have driven patient safety improvements at Johns Hopkins, across the United States and internationally.  The goal of the program is to build capacity among health professionals dedicated to becoming leaders for patient safety and quality in their unit, clinical department, or healthcare facility.  Focused on the application of knowledge and skills in simulated patient safety challenges, participants explore scenarios designed to help them achieve the following program objectives:

    1. Create and sustain a patient safety culture that has patient-centered care as its linchpin,
    1. Apply evidence-based practices to develop and support effective multidisciplinary teams that work in partnership with patients and their families to improve patient safety outcomes,
    1. Use a systems-based approach to identify and reduce defects,
    1. Develop patient safety initiatives for real and lasting change, and
    1. Act as change agents in their organization as they lead efforts to continuously learn from defects and improve patient safety and quality care.

The patient safety certificate program has been designed for delivery in two formats— a five-day, in-person program consisting of 24 modules and an online course consisting of 13 modules —that prepare participants for this critically important work.  The program covers essential topics such as patient safety culture, patient-centered care, safe design principles, and interdisciplinary teamwork and communication, along with strategies to engage their organizations in this critical work.  In addition, learners in the in-person program delve into performance improvement approaches such as Lean Sigma, human factors and design thinking.

These offerings are experiential and problem-based, giving learners frequent opportunities to apply the concepts they learn to realistic scenarios.  Participants are immersed in the key concepts, tools and skills that they need to reduce preventable harm to patients.  The patient safety challenges in this program go beyond theoretical.  Participants step into the shoes of a team at a virtual hospital that has very real problems.  As they are introduced to concepts and improvement tools, participants get frequent opportunities to apply them to realistic, engaging scenarios.  Additional learning strategies include: 1) Problem-solving in a "sandbox" environment that allows testing solutions with peers, 2) Networking with peers and Johns Hopkins instructors, and 3) Participating in an online community of patient safety and quality practitioners, before, during and after the program.

The program was designed to target the needs of anyone who would benefit from training in the core competencies and skills needed to guide and participate in patient safety improvement efforts. That includes unit- and clinic-level leaders and safety champions, patient safety officers, nurse managers, medical directors, risk managers, quality improvement professionals, as well as faculty in the health care professions.  Continuing nursing education and medical education credits are available for the program.


Program Evaluation: The in-person program was piloted in mid-2012 with a group of 21 Johns Hopkins-based participants.  Since that time, the program has been offered 7 times between February 2013 and December 2014, with a total of 207 participants (internal to Johns Hopkins, n=151; external, n=56) earning certificates of completion.  The online course was introduced in September 2013, and to date 339 have enrolled and 174 participants have earned certificates of completion (internal to Johns Hopkins, n=91; external, n=83).  


Participant knowledge is assessed pre- and post-program using a 38-item instrument assessing knowledge in the following key areas: science of safety, safe design principles, patient safety culture, patient-centered care, teamwork, high performance teams, communicating for patient safety, leadership, conflict management, event reporting and error disclosure, learning from defects, project management, and leading change.  In addition, a post-program survey is conducted to identify participant satisfaction and strengths and opportunities for improvement in the program.

Participant knowledge (mean + SD) increased significantly in key areas of patient safety improvement from baseline (64.83+13.64) to post program (93.51+ 6.56), p<0.001.  Participants reported high levels of satisfaction with the program format (both in-person and online), content, and outcomes.  Examples from participant feedback excerpts include: "This was one of the best run and most practical courses that I have ever attended. The week just flew by. Great instructors with practical examples, and lots of camaraderie with other participants. It was a really terrific learning experience."  "The course has re-energized my interest in patient safety. The presenters were multi-faceted, with backgrounds in research, business, health care and even the military. They provided real world examples of safety initiatives outside of health care that were translatable to the hospital and ambulatory settings. I was able to network in small groups with colleagues from other institutions who were passionate about patient safety allowing for great exchange of ideas. The sessions were very comprehensive touching upon all facets of safety, including Six Sigma and Lean. I would recommend the [certificate program] to other colleagues."  "The program is ideal for someone who is coming from the frontlines and taking a position in patient safety. It's a very inclusive introduction to a wide range of safety concepts...There's no more effective way to get these concepts."

Conclusion: Program evaluation demonstrated high levels of satisfaction with the program and improvements in knowledge in key areas of patient safety improvement.  Patient safety initiatives, both in the United States and internationally, have used this program to prepare key organizational safety leaders and build their organizations’ internal capacity for improvement.