Patient safety must start in classroom: report
Healthcare delivery continues to be unsafe and will probably remain that way for some time unless medical schools make substantial improvements in how they teach patient safety, according to Unmet Needs: Teaching Physicians to Provide Safe Patient Care, a report issued by the National Patient Safety Foundation’s Lucian Leape Institute.
The report charges that medical schools do an inadequate job of developing student understanding of concepts such as systems thinking, problem analysis and team collaboration that will help them become future architects of patient-safety and quality improvement efforts.
At a news conference, the institute’s namesake, Lucian Leape, the Harvard School of Public Health adjunct professor of health policy, added that “too often, the students are being educated in a toxic environment” where some 5% of physicians mistreat students and others and are allowed to “poison the well” and perpetuate a culture that hinders the collaboration that is needed for patient-safety learning to occur.
The report lists steps schools can take to mitigate these characteristics in future doctors by promoting attributes such as mindfulness, compassion, empathy and collaboration; screening and identifying school applicants with “sociopathic tendencies”; and monitoring students and intervening early if there are “displays of unprofessional or maladaptive behavior.”
John Prescott, the chief academic officer with the Association of American Medical Colleges, also spoke at the conference and said that, “Educating new doctors about patient safety is a top priority” of his organization and that many of the report’s recommendations have already been implemented.
The report’s authors agree somewhat and lists 23 medical schools where implementation has begun.
“One would hope that others will follow,” the report stated. “But hope is far from sufficient when the stakes are this high. Some ongoing credible mechanism is needed to monitor school progress toward, and, later, maintenance of achievement of, the objectives set forth herein.”
Patient-safety advocate Rosemary Gibson, author of the books Wall of Silence and The Treatment Trap (which is scheduled to be released on March 16), called the report “right on target,” and also had praise for the patientsafety focus for one particular school included among those listed by the report as already beginning the implementation of its recommendations: the University of Illinois at Chicago College of Medicine, which is also the nation’s largest medical school.
In addition to its medical school program, Gibson noted how the residency program at UIC encourages patient-safety discussions with requirements for reporting adverse events that they observe. “That approach is very rare,” she said. “I think the purpose of the Lucian Leape report is to make those types of active steps the norm rather than the exception.”