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Abstract
Objectives The improvement of safety in healthcare worldwide depends in part on the knowledge, skills and attitudes of staff providing care. Greater patient safety content in health professional education and training programmes has been advocated internationally. While WHO Patient Safety Curriculum Guides (for Medical Schools and Multi-Professional Curricula) have been widely disseminated in low-income and middle-income countries (LMICs) over the last several years, little is known about patient safety curriculum implementation beyond high-income countries. The present study examines patient safety curriculum implementation in LMICs.
Methods Two cross-sectional surveys were carried out. First, 88 technical officers in Ministries of Health and WHO country offices were surveyed to identify the pattern of patient safety curricula at country level. A second survey followed that gathered information from 71 people in a position to provide institution-level perspectives on patient safety curriculum implementation.
Results The majority, 69% (30/44), of the countries were either considering whether to implement a patient safety curriculum or actively planning, rather than actually implementing, or embedding one. Most organisations recognised the need for patient safety education and training and felt a safety curriculum was compatible with the values of their organisation; however, important faculty-level barriers to patient safety curriculum implementation were identified. Key structural markers, such as dedicated financial resources and relevant assessment tools to evaluate trainees’ patient safety knowledge and skills, were in place in fewer than half of organisations studied.
Conclusions Greater attention to patient safety curriculum implementation is needed. The barriers to patient safety curriculum implementation we identified in LMICs are not unique to these regions. We propose a framework to act as a global standard for patient safety curriculum implementation. Educating leaders through the system in order to embed patient safety culture in education and clinical settings is a critical first step.
- Change management
- MEDICAL EDUCATION & TRAINING
- Quality in health care
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Footnotes
Contributors LG, ND-K and LJD made meaningful contributions to the conception (objectives) and design of the study; LG led the work on survey instrument design with input from ND-K and LJD. LG and ND-K determined sampling approach, and LG was responsible for data collection and analysis. LG, ND-K and LJD participated in interpretation of data. LG drafted the initial manuscript including the PS curriculum implementation framework. ND-K and LJD critically revised the manuscript for intellectual content. LG, ND-K and LJD revised and approved the final version of the paper.
Competing interests None declared.
Patient consent Not applicable - patients are not part of this study.
Ethics approval WHO Research Ethics Review Committee; York University REB.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement No additional data are available.
Correction notice This paper has been amended since it was published Online First. Owing to a scripting error, some of the publisher names in the references were replaced with 'BMJ Publishing Group'. This only affected the full text version, not the PDF. We have since corrected these errors and the correct publishers have been inserted into the references.