Safety Coaches: Teaching Quality Improvement and Patient Safety in Residency Programs

摘要

To the Editor:Patient safety should be as central to medicine as the diagnosis and treatment of disease. The recent article by Schleyer et al1 assessed the use of an Advocate for Clinical Education (ACE) in teaching patient safety (PS) and quality initiatives. The authors found that this coach/feedback model for teaching PS and quality improvement (QI) demonstrated an improvement in professionalism and infection control. Although I believe that coaching and timely feedback are tools to promote change, I am unsure about the feasibility of hiring a part-time nurse to critique and provide feedback.One of the biggest issues residencies and medical schools face is the lack of time and knowledge to teach PS and QI.I commend the authors for trying to incorporate a curriculum at the bedside; however, with shrinking budgets it may not be feasible for hospitals to hire an additional staff member to provide this real-time feedback. Instead, I propose that one member of each resident team be designated the safety coach. The safety coach would conduct weekly patient safety rounds. These safety rounds would discuss QI and PS topics as related to specific patient encounters. By placing the responsibility back into the hands of the physician team, they can become more mindful of safety concerns and more invested in the safety of their patients. If all resident teams had weekly safety rounds, this would help ensure continuous QI. This clinician engagement is one of the key principles outlined by The National Quality Strategy for improving the quality of health care in the United States