EMBEDDING QUALITY AND SAFETY COMPETENCIES IN AN INTEGRATED CONCEPT AND COMPETENCY BASED CURRICULUM IN B.C., CANADASHANNON ELLIOTT, RN, MN, FACULTY, BCIT | THERESA SHAUGHNESSY, BSN, MHS, FACULTY, BCIT
PROBLEM
Current literature suggests that patient quality and safety concepts/competencies are not adequately integrated into curriculum of health care professions and large scale e� orts must be taken to embed these concepts into curriculums (Ginsburg, Castel, Tregunno & Norton, 2012).
BACKGROUND: CREATING A CONCEPT & COMPETENCY BASED CURRICULUM
In 2014, the BSN faculty identifi ed the need to do a complete revision of the curriculum and created a curriculum development team (CDT), composed of fi ve members to conceptualize a framework
After an extensive review of literature and other health care education programs, the CDT selected an integrated concept and competency spiraled approach for BCIT’s BSN program
CDT identifi ed key graduate attributes that were essential for BCIT BSN graduates to attain prior to graduation
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BCIT BSN graduates.Safe, ethical,competent,
compassionate.
BCIT BSN graduates:Safe, ethical,competent,
compassionate.
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BCIT BSN Graduate
Competencies were identifi ed for each of the 7 key graduate attributes and leveled for each year of the three year program
Quality and safety competencies were embedded within the graduate attributes Clinical evaluation is based on the attainment of the leveled competencies, including safety
quality competencies
WHY IS EMBEDDING QUALITY AND SAFETY COMPETENCIES INTO CURRICULUM IMPORTANT?
To develop students’ knowledge, skills, attitudes and values, linked to quality and safety competencies into nursing practice
To embed a process into the revised curriculum that ensures students demonstrate successful attainment of competencies related to quality and safety prior to graduation
Increasing complexity and advancements in health care require students to achieve competencies related to quality and safety
Paying attention to quality and safety competencies is a requirement for the delivery of high quality care
Student achievement of quality and safety competencies facilitates system improvements
DESIGNING AND EMBEDDING QUALITY AND SAFETY COMPETENCIES INTO CURRICULUM
BCIT patient quality safety committee was tasked by the CDT to complete needs assessment and recommendations for embedding quality and safety competencies to the revised curriculum
Course writers mapped the revised curriculum competencies to the following two learning objectives:
Develop skills to ensure the integration of patient quality and safety concepts in academic and clinical settings
Develop knowledge, attitudes and values to promote patient quality and safety concepts
STEPS
STRATEGIES TO SUPPORT STUDENT LEARNING
Canadian Patient Safety Institute (2016)
Nursing students are introduced to the concepts of quality and safety within six weeks of starting the nursing program at BCIT
Nursing students are expected to achieve quality and safety competencies in their fi rst clinical experience
Explicitly linked course outcomes to quality and safety concepts in the lesson objectives Active learning strategies used to engage the learner in the learning process within
experiential learning spaces such as refl ective practice, case studies, team based learning, role play and simulation
For example, In Term 1 , students are introduced in the fi ve dimensions of quality focused on the patient/client experience from both an individual as well as a system perspective:
Acceptability Appropriateness Accessibility Safety E� ectiveness
Students also focus on two dimensions of quality that focus on the performance of the system in which health care services are delivered:
Equity E� ciency
Nursing students are asked to apply the BC Patient Safety & Quality Council’sB.C. Health Quality Matrix in a clinical setting to a real life client experience
LESSONS LEARNED AND POTENTIAL PITFALLS
There is an increasing need to advance patient safety and quality education in healthcare Patient safety and quality concepts need to be identifi ed, mapped and spiraled to align with
the program/course competencies It’s not about the content but about e� ective teaching and facilitation strategies to think
critically and deeply about quality and safety Faculty require training to integrate quality and safety concepts into all experiential learning
spaces
NEXT STEPS
Continue to map and spiral patient safety and quality competencies to future curriculum revisions
Develop a standardized approach to teaching quality and safety so that consistent language and processes are used across all terms and spiraled throughout curriculum
Connect academic faculty with health industry Share resources and best practices with other nursing education programs in N. America
BSN term curriculum competencies
Map
safety/quality
competencies Learning
outcomes Assessment strategies
Active learning strategies
Spiral through
other courses /
Terms 1-9
Promote growth in clinical judgement required for the nurse in today’s healthcare industry
BC HEALTH QUALITY MATRIX / 6
BC HEALTH QUALITY MATRIX
STAYING HEALTHYPreventing injuries, illness, and disabilities
ACCEPTABILITY APPROPRIATENESS ACCESSIBILITY SAFETY EFFECTIVENESS
AREAS OF CARE
DIMENSIONS OF QUALITY
DIMENSIONS OF QUALITY
GETTING BETTERCare for acute illness or injury
LIVING WITH ILLNESS OR DISABILITYCare and support for chronic illness and/or disability
COPING WITH END OF LIFEPlanning, care and support for life-limiting illness and bereavement4
Care that is respectful to patient and family needs, preferences, and values
Care provided is evidence based and speci�c to individual clinical needs
Ease with which health services are reached
Avoiding harm resulting from care
Care that is known to achieve intended outcomes
DIMENSIONS OF QUALITY
DIMENSIONS OF QUALITY
EQUITY Distribution of health care and its bene�ts fairly according to population needEFFICIENCY Optimal use of resources to yield maximum bene�ts and results
4 Descriptor re�ects direction of the Ministry of Health and input from the Provincial End of Life Standing Committee.
In 2008, the BC Health Quality Matrix was developed in collaboration with the members of the Health Quality Network which included BC’s Health Authorities, Ministry of Health Services, academic institutions and provincial quality improvement groups and organizations.
.............................. Guiding Principles ...........
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Knowledge
Skills Values
Attitudes
Com
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Core
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Professional
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Advocate
ProfessionalProfessionalProfessionalProfessionalProfessionalProfessionalProfessionalProfessionalProfessionalProfessionalProfessionalProfessionalProfessionalProfessionalProfessionalProfessionalProfessionalProfessionalProfessionalProfessionalProfessionalProfessionalProfessionalProfessionalProfessionalProfessionalProfessionalProfessionalProfessionalProfessionalProfessionalProfessionalProfessionalProfessionalProfessionalProfessionalProfessionalProfessionalProfessionalProfessionalProfessionalProfessionalProfessional
Communicator
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BCIT BSN graduates.Safe, ethical,competent,
compassionate.
BCIT BSN graduates:Safe, ethical,competent,
compassionate.
AdvocateAdvocateAdvocateAdvocateAdvocateAdvocateAdvocateAdvocateAdvocateAdvocateAdvocateAdvocateAdvocateAdvocateAdvocateAdvocateAdvocateAdvocateAdvocateAdvocateAdvocateAdvocateAdvocateAdvocateAdvocateAdvocateAdvocateAdvocateAdvocateAdvocateAdvocateAdvocateAdvocateAdvocateAdvocateAdvocateAdvocateAdvocateAdvocateAdvocateAdvocateAdvocateAdvocateAdvocateAdvocate
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BCIT BSN Curriculum Model
IDENTIFY DESIRED RESULTS
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EVIDENCE
PLAN LEARNINGEXPERIENCE
AND INSTRUCTION
BCIT (British Columbia Institute of Technology) is a post-secondary institute in Burnaby, BC, Canada. The Bachelor of Science in Nursing (BSN) is a three year program o� ered as part of the health sciences fi eld of studies. The program prepares highly skilled practice-ready nursing graduates to practice in both hospital and community settings bcit.ca/study/programs/8870bsn.
