Supply and Demand: Meeting the Need for Graduate Training in Patient Safety

Abstract

Every Spring at graduation for the Johns Hopkins Bloomberg School of Public Health, our former dean used to stand on stage before a sea of black robes, and vigorously proclaim “This is the happiest day of the year!” I found myself recently remembering that feeling. It was the evening before graduation, and I hosted a reception for the graduates of our online Masters of Applied Science in Patient Safety and Healthcare Quality. Because the program is fully online, part-time, and designed for working professionals, the majority of students had never visited our campus, and had never met other students in-person. It was remarkable to see just how many of them showed up – more than half of our 77 graduates. They appeared from as far away as the United Kingdom and the Philippines, some driving cross country with families in tow, all dressed to the nines. For them, it was an auspicious moment. One student observed that it was the first time that they had met one another, and likely the last time they would see each other. But that is not to say that they had not gotten to know their classmates, over at least two years spent completing course requirements. Most had bonded early with fellow students on-line, with whom they talked for hours about class assignments, as well as about work and everyday life. It was heartwarming to witness pairs of study-buddies meeting for the first time in person, with squeals of recognition and joy, hugs, and selfies. Students shared war stories, and recalled favorite professors and classes. Their passion and zeal were palpable. Earning an advanced degree in patient safety and quality was a watershed that had already carried several of them to new posts and careers. This moment, however, is all too rare. In the last two decades, Patient Safety and Healthcare Quality has emerged as a new field of research and practice. As the emphasis has increased on providing evidence-based, high quality, high value care, so has work to prevent adverse events, misuse of treatments, and inconsistent delivery of care. But until recently, researchers and practitioners entered the field through degrees in other fields: medicine, nursing, public health, health informatics, management or administration, or other established professions. For example, I got into patient safety after completing training in internal medicine, when the topic was still referred to as “medical error.” Although today patient safety is a priority for all health care organizations, the requisite training is neither widely nor evenly distributed. In the US, there is still relatively small number of graduate level programs specifically focused on patient safety and quality. There are increased opportunities in education and training that have grown up organically. These vary widely in topic, level of expertise, duration, cost, location, modality, intended audience, and who delivers the material. But they are not coordinated. Some offerings focus on a specific topic, such teamwork and communication, or just culture. The level of training varies from introductory to expert. Some courses are offered on a one-time basis, some as short courses lasting a few days, some longer. Courses may be tuition bearing, or free, such as the Massive Open Online Courses (MOOCs) offered by Coursera. Some are offered at a specific time and place, often at a conference or professional meeting. The modality may be in-person or on-line, synchronous or asynchronous. Some durable materials are archived and available as needed. The material may be aimed at a single profession or speciality, while other offerings are designed for individuals across all settings of care and specialties. Material may concentrate on a specific clinical problem, or method or tool. Some courses generate credits for continuing education, or credentials, like the Certified Professional in Patient Safety. Opportunities are offered by academic institutions, government agencies, not-for-profits, member organizations, and private groups. There has been some movement towards universal education in patient safety for health professionals at the undergraduate level. The World Health Organization’s Multi-Professional Patient Safety Curriculum Guide has been adopted in whole or in part in many countries, and is currently being updated. But there is an urgent need for leaders and innovators in the field. Increasingly, hospitals and other health care organizations have patient safety departments. There is also a growing list of associated professional titles, ranging from Patient Safety Officer to Vice President of Patient Safety and Quality. Advanced knowledge and skills are required to lead improvements in safety and quality, and to transform the culture of organizations. Graduate training in patient safety and quality can provide healthcare professionals with the knowledge, attitudes, and skills to be effective leaders in this field. Editorial