HRSA-Funded Collaborative Patient Safety Training to Address ACGME Core Competencies

Presenter: Ranjit Singh, MD, MBA

Institution: Department of Family Medicine, SUNY at Buffalo, New York

Co-Authors: John Taylor, Bruce Naughton, Brian Connolly, Marlon Koenigsberg, Diana Anderson, Linda McAusland, Robert Wahler, MD, Amanda Robinson, Gurdev Singh

Introduction: Patient Safety and Medical Errors currently receive only scant attention in most residency curricula. The Department of Health and Human Services recommends that education be done collaboratively, that is, those who work together should train together. The ACGME has recently introduced new accreditation rules requiring all residency programs to document training and evaluation of residents in six specific core competencies: Patient Care, Medical Knowledge, Practice-based Learning, Communication, Professionalism, and System-based Practice. Objective: In collaboration with the Schools of Nursing and Pharmacy, to design and implement (with federal funding) a new Patient Safety Curriculum for Family Medicine Residents in such a way as to address all six of the ACGME core competencies.

Methods: Introduction of a new patient safety curriculum and on-going evaluation of program effectiveness.

Setting/ Participants: University-based Family Practice residency program with 5 ambulatory sites including urban, suburban and rural sites. Forty-five Residents.

Intervention: Curriculum includes an introductory workshop, a progressive series of didactic courses, and a series of group exercises including role-plays, response to video-vignettes, chart reviews, monthly journals, presentations of journal cases, and a longitudinal safety-enhancement project. The activities are run by a multidisciplinary team that visits each residency site it turn.

Main Outcome Measures: Performance in the above activities is evaluated using competencies and includes standardized patient interviews, response to vignettes (video and written), and review of standardized charts.

Results: OSCE results will be compared to baseline data. Implementation issues and difficulties faced will be discussed.

Conclusions: Introduction of a new curriculum for patient safety posed logistical and motivation problems, but shows considerable promise for enhancing family medicine residency training and may serve as a model for meeting ACGME competency requirements.