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Medical and nursing students team up to help prevent a mock patient from falling during a clinical dramatization in the medical school's Russell D. and Mary B. Shelden Clinical Simulation Center. While the introduction of the fall curriculum into medical and nursing students' educational experience is new, the schools have been developing interprofessional curriculum on quality, patient safety and teamwork since 2003.


MU Students First to Pilot New Quality Improvement and Safety Curriculum


Medical and nursing students collaborate to assess risks and prevent patients from falling

Students are learning more about medical teamwork and hands-on problem solving as a result of a new pilot project at the MU School of Medicine and Sinclair School of Nursing. MU was recently chosen as one of six national sites to participate in Retooling for Quality and Safety, a quality improvement and safety initiative funded by the Institute for Healthcare Improvement (IHI) and the Josiah Macy Jr. Foundation.

The yearlong curriculum project places MU third-year medical students in collaborative teams with nursing students to assess patients' risk of falling and help prevent them from falling while at the hospital or in their homes.

Linda Headrick, MD, MU School of Medicine senior associate dean for education and faculty development and a professor of internal medicine, is the lead academic adviser for the national IHI project team. She said that MU students are first to benefit from the new curriculum. They will be joined by students elsewhere in developing new ideas that will serve as a model for other educational institutions.

"If we want to have health workforce members who are ready, able and expecting to improve care as part of their role as professionals, then it needs to be part of their education as professionals," Headrick said. "We want to come up with a set of recommendations that make it easier for other schools to integrate quality improvement and patient safety into their core curriculum."

Carla Dyer, MD, assistant professor of internal medicine and the medical school's project team leader, said fall risk was chosen as a focus because hospitalized patients are considered at high risk of falls, which can result in further complications for those who may already be in a fragile state of health. According to recent research, a patient falling in the hospital is associated with injury 39 to 42 percent of the time and serious injury in 8 to 13 percent of circumstances.

The new curriculum reinforces the fundamentals of patient safety and quality improvement, introduces students to ongoing improvement initiatives at University Hospital and places them at the bedside to make a direct impact on their patients' health and safety. Medical and nursing students first complete interactive Web-based training on fall risk-assessment and prevention. They then work in pairs to assess patients for fall risk, and provide each patient and care team with individual recommendations for fall prevention. After caring for patients, they participate in small-group discussions with faculty members and in a grand rounds lecture on the topic of patient safety and falls.

While the introduction of the fall curriculum into medical and nursing students' educational experience is new, the schools have been developing interprofessional curriculum on quality, patient safety and teamwork since 2003. Second-year medical and senior nursing students participate in a case analysis with pharmacy, respiratory therapy and health management students to learn the basic principles of quality improvement and patient safety. In 2009, a collaborative exercise in the MU School of Medicine Russell D. and Mary B. Shelden Clinical Simulation Center was added to the curriculum.

"This new IHI curriculum project will extend what we currently do," Headrick said. "It will allow us to take that learning to a deeper level, both in terms of interprofessional collaboration and in terms of quality improvement and safety."

Other educational institutions participating in Retooling for Quality and Safety include The Johns Hopkins University School of Medicine; Penn State College of Medicine; the School of Medicine at the University of Texas San Antonio Health Science Center; the University of Colorado Denver School of Medicine; and Case Western Reserve University School of Medicine. Each site receives $35,000 to fund the project.

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