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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Communicator

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BCIT BSN graduates.Safe, ethical,competent,

compassionate.

BCIT BSN graduates:Safe, ethical,competent,

compassionate.

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BCIT BSN Curriculum Model

IDENTIFY DESIRED RESULTS

DETERMINEACCEPTABLE

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.