In designing a curriculum for “learning and performing quality improvement work”, we have exploited the fundamental principles of Continuous Quality Improvement (CQI) in the evaluation and reconstruction of the course modules. The Faculty of Health Sciences (FHS) has in close collaboration with the County Council of Ostergotland (CCO) developed a learning module based on a mutual interest of increased knowledge in CQI. Hence, we have integrated students learning to the learning among professionals in the everyday work at the clinics.
To be powerful, improvement of quality and safety (IQS) should be performed by all involved health professionals and patients in cooperation. Since the mid-80ies, all students at FHS have been engaged in educational modules within their undergraduate programs aiming at the development of interprofessional competence. We believe that interprofessional competencies is one of the key elements for working with CQI in healthcare.
In addition, at the FHS, all curricula are based on Problem-Based Learning (PBL). The procedure (PDSA-cycle) for CQI-work has great similarities to the process for PBL. Hence, CQI and PBL reinforce the way individuals identify and solve problems in addition to needs of learning.
Since 2008, students from all our undergraduate programs learn CQI-methodology in personal improvement projects during the first semester, as part of the curricula for interprofessional learning. The partnership with the CCO now includes practice of CQI in clinical settings. In close collaboration with the staff from primary health care centers or clinical wards, interprofessional student groups identify and explore areas of quality and safety improvement and suggest interventions that are evaluated. For example; i) use of search-terms in a web-based medical record system, ii) accessibility to acute care, or iii) reception of frequent visitors in primary health care. The suggested interventions and conclusions were well received, discussed and developed at the clinics.
The project group designing the learning module evaluated the design in a small test with three students groups. The experiences and results were scrutinized and minor improvements were implemented in the following semester, with an increased number of student groups. Examples of improvements were i) the description of the expected contribution from the clinical staff, ii) modification of the estimated “size” of the improvement work, and iii) how students are introduced to “the problem of clinical interest”. After four test-cycles we are now engaging all thirty groups of undergraduate students (total 320 students) in the CQI –projects.
Our learning in the project group has been challenging, coming from two different working cultures with different approaches to quality, different management etc. However, we strongly support the design for integrated learning between academy and practice, students and professionals, and novices with experts.
International Forum on Quality and Safety in Health Care, 5-8 April, 2011, Amsterdam