Free e-Course ~ Patient Safety and Medical Errors

Patient Safety and Medical Errors

VU Course ID:	HM329
Curriculum:	9 lectures
Fee:	FREE
Textbooks:	None
Prerequisites:	None
Instructors:	Albert Wu, Laura Morlock, and Peter Pronovost
Provider:	Johns Hopkins School of Public Health
Recordable:	Yes / 2 CEUs

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Course Description

This course provides an introduction to the science of safety and how it relates to problems with patient safety in health care. It examines the role of individuals and systems in improving patient safety, and reviews institutional responses to adverse events, including medical malpractice. Students will learn the basics of conducting an incident investigation, gain an understanding of the advantages and limitations of error reporting, learn how to disclose errors and adverse events, and learn models for improving safety in hospitals and other health care organizations from both the micro and macro points of view.

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Lecture 1 –

Science of Safety Discuss and distinguish individual and system factors that cause accidents Recognize the contribution of human factors to error causation

Lecture 2 –

Adverse Events and Safety Concepts and Definitions

Lecture 3 –

The IOM Report Synthesize the key points found in seminal reports

Lecture 4 –

Safety and Medicine Evaluate the evidence that medical errors are a leading cause of death and injury

Lecture 5 –

Systems of Influence Describe how four systems of organizational influence affect patient safety

Lecture 8 –

Measuring Patient Safety Recognize some of the challenges to measuring patient safety; explain an approach to measuring aspects of safety in clinical practice

Lecture 9 –

Adverse Event Reporting Systems Discriminate between voluntary and mandatory reporting systems; synthesize the lessons that aviation reporting systems have for medical reporting; recognize the characteristics of successful reporting systems

Lecture 10 –

Reporting Medical Errors Real-Time Tales; describe a widely used voluntary incident reporting system; discuss the strengths and limitations of such a system

Lecture 11 –

Investigating a Defect Describe the techniques for investigating adverse events; identify the system factors that lead to a medical error; identify the relationship between active failures and latent failures

Lecture 12 –

Interventions to Improve Patient Safety

Lecture 13 –

Practical Tools to Improve Patient Safety Describe how a comprehensive unit-based safety program is conceptualized and implemented

Lecture 14 –

CUSP Designing a Comprehensive Unit-based Patient Safety Program. Describe how policy, payment, accreditation, and education can contribute to safety. analyze websites of national patient safety and quality organizations

Lecture 15 –

Medication Safety Provide a four-stage conceptual model for medication safety initiatives at the facility level; discuss at a conceptual level the multiple steps of an adverse event reporting system as applied to medication errors; analyze examples of different types of medication errors that have been reported to the MEDMARX system, including errors in post-anesthesia care units (PACUs) and errors associated with infusion-related medication administration

Lecture 16 –

Disclosure of Adverse Events and Medical Errors Discuss the argument for disclosure of adverse events to patients; iIdentify components of a good disclosure discussion

Lecture 17 –

The Joint Commission and Patient Safety

Lecture 18 –

Macrosystems Policy, Payment, Regulation, Accreditation, and Education to Improve Safety;

Lecture 20 –

Adverse Events in the Outpatient Setting

Lecture 21 –

An Overview of the Patient Safety Programme at WHO

Lecture 22 –

Clean Care Is Safer Care

Lecture 23 –

Overview of STOP-BSI Program

Lecture 24 –

Where Are We Now?

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