Evaluation of the training program efficiency on medical errors and patient safety

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Bruno Krug
Anne-Sophie Cornet
veronique nonet
jacques jamart
Isabelle Labar
veronique gerard
François-Marie gerard
dominique van pee


BackgroundThe success of incident reporting in improving safety will depend on the awareness of the personnel about medical errors. To improve patient safety, we organised a 1/2-day program including a plenary session and a small group discussion on a multidisciplinary analysis of a case-study with a fishbone diagram.PurposeThe purpose of the study was to evaluate the training efficiency on attitudes and beliefs of the personnel on patient safety and their attitudes towards the voluntary reporting of incidents.Material and MethodsAll the frontline healthcare professionals were invited to participate. Knowledge, attitudes and beliefs were measured by a 7-question survey at the beginning and end of the program. We calculated the mean training efficiency gain, which is defined as the ratio of the raw gain/maximal possible gain and the correlation between the knowledge gain and the global satisfaction of the program.ResultsThe 1/2-day program was attended by 590 frontline healthcare professionals. Completed surveys were returned by 464 (79%) participants. The overall questions scores increased significantly from a pre-test mean of 6.5+/-1.4 to a post-test mean of 8.3+/-0.9. All the questions changed in the expected direction with mean training efficiency gain of 45.9% (38.0 to 53.4%). There was a positive correlation between the knowledge gain and the global satisfaction (r=0.215, p<0.001). ConclusionThese findings documented the positive impact of the program, on knowledge, attitudes and beliefs of the personnel about medical errors and patient safety. They were especially impressive given that the program entailed only 1/2 day’s effort. Longitudinal follow-up is required to provide more information on the lasting impact of the module.

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Leape, L.L. (2009). Errors in medicine. Clinica Chimica Acta 404, 2-5.

Linda, K., Janet, C. & Molla, D. (2000). To err is human: building a safer health system. Committee on Quality of Health Care in America, Institute of Medicine edn, Washington.

Reason, J. (2004). Beyond the organisational accident: the need for "error wisdom" on the frontline. Quality and Safety in Health Care 13 (Supplement 2) ii28-33.

Jansma, J.D., Zwart, D.L., Leistikow, I.P., Kalkman, C.J., Wagner, C. & Bijnen, A.B. (2010). Do specialty registrars change their attitudes, intentions and behaviour towards reporting incidents following a patient safety course? BMC Health Services Research 10, 100.

Woodward, H.I., Mytton, O.T., Lemer, C. Yardley, I.E., Ellis, B.M., Rutter, P.D., Greaves, F.E., Noble, D.J., Kelley, E. & Wu, A.W. (2010). What have we learned about interventions to reduce medical errors? Annual Review of Public Health 31, 479-497.

Anderson, E., Thorpe, L., Heney, D. & Petersen, S. (2009). Medical students benefit from learning about patient safety in an interprofessional team. Medical Education 43, 542-552.

Flanagan, B., Nestel, D. & Joseph, M. (2004). Making patient safety the focus: crisis resource management in the undergraduate curriculum. Medical Education 38, 56-66.

Mayer, D., Klamen, D.L., Gunderson, A. & Barach, P. (2009). Designing a patient safety undergraduate medical curriculum: the Telluride Interdisciplinary Roundtable experience. Teaching and Learning in Medicine 21, 52-58.

Patey, R., Flin, R., Cuthbertson, B.H., MacDonald, L., Mearns, K., Cleland, J. & Williams, D. (2007). Patient safety: helping medical students understand error in healthcare. Quality and Safety in Health Care 16 (4) 256-259.

Wakefield, A., Attree, M., Braidman, I., Carlisle, C., Johnson, M. & Cooke, H. (2005). Patient safety: do nursing and medical curricula address this theme? Nurse Education Today 25, 333-340.

D’Hainaut, L. (11975). Concepts et méthodes de la statistique. Brussels: Labor.

Gerard, F.M. (2000). L’évaluation de l’efficacité d’une formation. Gestion 20, 13-33.

Clancy, C.M. (2005). Training health care professionals for patient safety. American Journal of Medical Quality 20, 277-279.

Elston, D.M., Stratman, E., Johnson-Jahangir, H., Watson, A., Swiggum, S. & Hanke, C.W. (2009). Patient safety: Part II. Opportunities for improvement in patient safety. Journal of the American Academy of Dermatology 61, 193-205, quiz 206.

Flin, R. & Patey, R. (2009). Improving patient safety through training in non-technical skills. British Medical Journal 339, b3595.

Anderson, B., Stumpf, P.G. & Schulkin, J. (2009). Medical error reporting, patient safety, and the physician. Journal of Patient Safety 5, 176-179.

Evans, S.M., Berry, G., Smith, B.J., Esterman, A., Selim, P., O'Shaughnessy, J. & DeWit, M. (2006). Attitudes and barriers to incident reporting: a collaborative hospital study. Quality and Safety in Health Care 15, 39-43.

Grzybicki, D.M. (2004). Barriers to the implementation of patient safety initiatives. Clinics in Laboratory Medicine 24, 901-911, vi.

Neale, G., Vincent, C. & Darzi, S.A. (2007). The problem of engaging hospital doctors in promoting safety and quality in clinical care. Journal of the Royal Society for the Promotion of Health 127, 87-94.

Mahajan, R.P. (2010). Critical incident reporting and learning. British Journal of Anaesthesia 105 (1) 69-75.

Kerfoot, B.P., Conlin, P.R., Travison, T. & McMahon, G.T. (2007). Patient safety knowledge and its determinants in medical trainees. Journal of General Internal Medicine 22, 1150-1154.

Coyle, Y.M., Mercer, S.Q., Murphy-Cullen, C.L., Schneider, G.W. & Hynan, L.S. (2005). Effectiveness of a graduate medical education program for improving medical event reporting attitude and behavior. Quality and Safety in Health Care 14, 383-388.

Flin, R., Patey, R., Jackson, J., Mearns, K. & Dissanayaka, U. (2009). Year 1 medical undergraduates' knowledge of and attitudes to medical error. Medical Education 43, 1147-1155.

Madigosky, W.S., Headrick, L.A., Nelson, K., Cox, K.R. & Anderson, T. (2006). Changing and sustaining medical students' knowledge, skills, and attitudes about patient safety and medical fallibility. Academic Medicine 81, 94-101.

Moskowitz, E., Veloski, J.J., Fields, S.K. & Nash, D.B. (2007). Development and evaluation of a 1-day interclerkship program for medical students on medical errors and patient safety. American Journal of Medical Quality 22, 13-17.

Paxton, J.H. & Rubinfeld, I.S. (2010) Medical errors education: A prospective study of a new educational tool. American Journal of Medical Quality 25 (2) 135-142.