Improvements in health care are slow, in part because doctors and nurses lack skills in quality improvement, patient safety, and interprofessional teamwork. This article reports on the Retooling for Quality and Safety initiative of the Josiah Macy Jr. Foundation and the Institute for Healthcare Improvement, which sought to integrate improvement and patient safety into medical and nursing school curricula. In one academic year, 2009-10, the initiative supported new learning activities (87 percent of which were interprofessional, involving both medical and nursing students) in classrooms, simulation centers, and clinical care settings that involved 1,374 student encounters at six universities. The work generated insights-described in this article-into which learning goals require interprofessional education; how to create clinically based improvement learning for all students; and how to demonstrate the effects on students' behavior, organizational practice, and benefits to patients. A commonly encountered limiting factor for the programs was the lack of a critical mass of clinically based faculty members who were ready to teach about the improvement of care. What's more, the paucity of robust evaluation strategies for such programs suggests a future research agenda that deserves to be funded.

译文

医疗保健的改善缓慢,部分原因是医生和护士缺乏质量改进,患者安全和专业团队合作方面的技能。本文报道了Josiah Macy Jr的质量和安全重组计划。基金会和医疗保健改善研究所,试图将改善和患者安全纳入医疗和护理学校课程。在2009-10的一个学年中,该计划支持了教室,模拟中心和临床护理环境中的新学习活动 (其中87% 是跨专业的,涉及医学和护理学生),涉及六所大学的1,374学生相遇。这项工作产生了见解-在本文中描述-学习目标需要跨专业教育; 如何为所有学生创建基于临床的改进学习; 以及如何证明对学生行为,组织实践和对患者的利益的影响。该计划通常遇到的限制因素是缺乏足够数量的临床教职员工,他们准备教授有关改善护理的知识。更重要的是,缺乏针对此类计划的强大评估策略,这表明未来的研究议程值得资助。

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