Curriculum evaluation tool
You can download the tool here (pdf).
Introduction
This tool is intended for the evaluation of the education curricula and study unit descriptions of the social welfare and healthcare sectors. The evaluation is focused on the education of client and patient safety.
Participants to the tool’s development work have included specialists from the Finnish Centre for Client and Patient Safety, specialists of the social welfare and healthcare sectors from wellbeing services counties and from various educational institutions.
The contents are based on the WHO’s Multi-professional Patient Safety Curriculum Guide, 2011. The tool was created based on the content recommended by the WHO, applying them to the Finnish context while taking into account the changes in the social welfare and healthcare operating environment. The topics added to the tool are the safety of devices and equipment, and the safety of the operating environment.
Expertise in client and patient safety is part of the basic knowledge and skills for social welfare and healthcare professionals
The expertise of social welfare and healthcare professionals is essential when seeking to prevent mistakes and harm in services and care. Client and patient safety expertise must systematically be promoted in basic education and maintained in further and supplementary education.
The purpose of this tool is to help parties providing education in their work on planning curricula, planning the goals and contents of study units and examining implemented curricula and study units.
During the development work, the tool was tested at the Oulu University of Applied Sciences’ degree programmes for Nursing and Health Care, Preventive Health Care, Midwifery and Social Services. The teachers found that client and patient safety is integrated into many different study units in the programmes. It was also found that client and patient safety was promoted well with very diverse learning methods, such as lectures, videos, workshops, role play, simulations and gamification. Guided practice also plays an important role in the learning of client and patient safety.
Teachers found the evaluation of curricula and study unit descriptions eye-opening. They felt that the structure and content of the tool help educators in their work on curricula and the development work of study units. The tool helps teachers understand the scope of client and patient safety. It also helps identify the core and foundation for teaching the knowledge, skills, attitudes and culture related to safety training for each professional field. Another important observation was that there is a need for collaboration between the various degree programmes. Client and patient safety is everyone’s shared goal.
Contents of the tool
In the tool, client and patient safety has been broken down into 13 learning topics. They are based on the WHO’s patient safety curriculum structure applied to the Finnish operating environment.
Use of the tool
The evaluator examines the curriculum of the programme to be assessed, as well as the descriptions of all its study units. The evaluator goes through the 13 topics presented in this document one by one and evaluates whether their topics, concepts, goals and contents are included in the learning outcomes and content of the programme’s study units. An Excel sheet can be used to support the evaluation.
Each of the 13 topics has sections for content and learning outcomes. The “Content” section describes the theoretical content of the topic, while the “Learning outcomes” section includes more practical issues related to each topic. In topics 1, 3, 12 and 13, content and learning outcomes are presented as one section.
When all the programme’s study units have been examined for each topic, the evaluator can make an overall evaluation regarding the curriculum’s client and patient safety. The topic contents have been planned so that they might cover the full scope of client and patient safety in the social welfare and healthcare sectors as comprehensively as possible.
Evaluators should apply the tool to the curriculum and study units to be examined by selecting content within the topics that is essential to the programme in question. The tool can be modified to suit the needs of each degree programme.
Content and learning outcomes
Definition of patient safety
Definition of client safety
Terms and concepts of client and patient safety
Patient safety from the perspective of patients, friends and family, patient-oriented approach
Client safety in the social welfare sector and in rehabilitation, client-oriented approach
History of patient safety and development into its current state
- blaming, blame culture
- impacts of blaming if the focus is on individuals instead of systems
- systems theory, systemic errors
Patient safety work relative to quality work
- patient safety procedures
What can we learn from other fields?
Evidence-based treatment
Professional ethics
Organisation of safety work
Responsibilities and obligations in client and patient safety
Laws, decrees and regulations
Client and patient safety strategy
Self-monitoring programme
Self-monitoring plan
Why is it important to take human factors into account for safety?
How do the physical, psychosocial and digital work environments affect a person’s ability to work safely?
How do stress and fatigue affect a person’s assessments, decision-making and performance?
Content
Onboarding
Overall onboarding, safety onboarding
Recognising the limits of competences
Personnel wellbeing
Human performance
Ergonomics
- physical
- organisational
Ethical principles
Ethical stress
Psychological safety
Employee’s wellbeing and capacity after harmful incident or near miss
Debriefing procedures, Second Victim protocol
Learning outcome
Operating methods and attitudes
- professional
- ethical
Safety culture
Organisational and individual operating culture
Client and patient safety culture
- clients, patients and next of kin as contributors to the safety culture
Personal values and beliefs, including unconscious ones
Continuous learning and feedback
Learning from own mistakes and the mistakes of others
Constructive discussion atmosphere, ability to discuss problems
- quality of care or client/patient safety
- bullying, harassment or disparagement (how to intervene? how to prevent?)
Wellbeing at work
- work management
- coping (recognising the limits of coping ability)
- taking care of your own wellbeing
- risks to work ability and safety related to your own health
- stress management skills
Resources and funding
sufficient personnel and resources as a safety factor
How can systems thinking improve social welfare and healthcare, as well as minimise harmful events?
Content and learning outcomes
System, complex system, reliable organisation
- high reliability organisation (HRO)
Monitoring, measurement, evaluation
Event, event monitoring
The role of systemic errors (organisation-level errors) in ensuring safety
Risks, risk awareness and risk management
- clinical risk, risk assessment
Social welfare and healthcare risks due to complex processes and multi-professional work
What is good teamwork, and how does it affect client and patient safety?
Content
Safe teamwork and safe communication
Team, roles, responsibilities, leadership, values, assumptions, communication, listening skills, learning styles, conflict resolution
Workplace community skills and teamwork
Multidisciplinary and multi-professional approaches
Multi-professional and consistent competences in client and patient safety
The roles of specialised fields and other healthcare and social welfare professionals, and respecting their expertise and professional skills
Being an effective team player
The responsibilities and obligations of teamwork
Prioritisation and decision-making in a team
Multiple casualty incidents and major accidents
Organisational learning
Learning outcome
Note that you are a member of multiple teams.
Clear communication
- Safe, clear and appropriate transfer of data
- speech
- writing
- electronic communication
- Ensuring the continuity of care when transferring the burden of care from one party to another
- upon change of shift or ward
- data transfer between systems
- Reporting and ISBAR
- Identify
- Situation
- Background
- Assessment
- Recommendation
Collegiality, working in the best interests of the client/patient
Intervening in unprofessional work
Characteristics of a successful team
- CRM – Crew Resource Management
How can we learn from mistakes in social welfare and healthcare and improve safety?
Content
Understanding the nature of a mistake
Mistake, abnormality, near miss, deviation
Oversights and lapses caused by a lack of competence versus mistakes
Situations linked with an increased risk of mistakes
Root cause analysis
Quality deviations
Appeals
Objections and complaints
Safety event reports and developing operations based on reports
Reporting mistakes and near misses
Reporting safety events and harmful events, reporting systems
Hotline indicators (Never Events)
Open and honest discussion of mistakes with clients/patients, healthcare professionals and supervisors
Learning from mistakes
Learning outcome
Reports
Filing a report
Processing
Medication safety
Device safety
Deficiency report
Statutory reporting obligations and rights
The reporting obligations of professionals include
- child welfare notification
- report regarding suspicion of crime against a child
- social care support need
- service need for an older person
- reporting obligation regarding a deficiency in the implementation of social care
- separate reporting obligation for doctors regarding diminished driving health
- reporting obligation for healthcare professionals regarding a threat to traffic safety
- obligation to report a risk of fire or accident
- reporting obligation for doctors and dentists regarding infectious diseases
The reporting rights of professionals include
- reporting activities endangering patient and client safety
- use of intoxicants affecting driving health
- state of health of a holder or applicant of a passenger transport licence
- diagnosed or suspected adverse effects related to use of medication
- diagnosed or suspected adverse effects of vaccinations
How are the principles of risk management applied to identify, assess and report deviations and potential workplace risks?
Content
Clinical risk, risk assessment, event, event monitoring, reporting of near misses
Identify, investigate and learn
Risk identification and reporting
Use of indicators
Experiences, views and complaints of patients and their friends and family
Patient safety II, learning from what goes right
Learning outcome
Assessment and monitoring of patient safety
Logging, documenting, structured logging
Improving safety culture
The utilisation of risk management principles to identify and assess hazardous situations and potential risks at the workplace, e.g. the role of complaints in developing safety and care.
Risk areas, medical errors and special situations
Identification of situations and circumstances with an elevated risk of harm to patients or clients, and the management of such risks
Prevention of falls and bed sores, risk inspection
Suicides during treatment period
Prevention of infections related to treatment
Resources and funding: sufficient personnel and resources as a safety factor
Radiation safety
High-risk medication
Accessibility checklist
Reporting and processing serious safety events
Preparedness and patient safety
Emergencies and exceptional situations
Prevention, risk identification and management of threatening and dangerous situations
Analysis of the progression of a dangerous situation with root cause analysis tools
Crises and catastrophes: accidents, chemical/biological risks in radiation or nuclear accidents
Normal situation versus Raised preparedness versus Catastrophe scenario
- plans and principles
- plans for exceptional circumstances
- catastrophe drills
Content
Quality work, analysis, reporting
Quality improvement methods in improvement of services
Evidence-based action
Service quality and patient/client satisfaction
Systems thinking, theory and framework
Systems thinking, systemic error
View on patient safety over time
- before and now
- individual and system
Safety in a complex (adapting) system
Process thinking
- integrating safety in processes, decision-making and organisational structures
- quality of treatment, care and services from the perspective of processes
High reliability organisation (HRO)
Management, guidance and leadership of safe treatment
Safety management system
Management system for differing circumstances
Reliable and safe work environment
Processing and communicating about risks and mistakes
Support for employees
Quality management principles and application
Significance of quality registers and treatment outcome benchmarking
Learning outcome
Quality improvement
PDSA cycle
Terms and concepts related to change
Variation
Quality improvement methods
Quality improvement tools
Flowcharts
Cause-and-effect diagrams (Ishikawa/fishbone diagrams), Pareto charts, histograms, operation diagrams
Safe processes and working methods
Understanding the organisation, processes and working methods in a complex system
Implementing processes, methods and working methods
Safe data transfer and continuity within a ward and between wards
Care pathways and digital care chains – client/patient-oriented approach
Electronic client and patient data systems (functionality)
Continuous learning
Content
Client and patient safety together with clients/patients and their friends and family
Client/patient-orientedness
Informed decision-making
Including clients/patients and their friends and family in the care and care planning at all stages of care
Providing information regarding alternatives to examinations and treatments as well as likely benefits and possible negative impacts so that clients/patients can make justified decisions on their care
Including clients/patients and their friends and family in systematic client and patient safety work
Equality, equity, non-discrimination
Health differences, social and socio-economic background factors, risks caused by work or living environment
- effects on the course of diseases and success of treatments
- mitigation of effects
Age, gender, language
Poverty, homelessness, marginalisation.
Immigrants/multiculturalism
Culture-specific issues, cultural norms, understanding the principles of society
Refusing treatment – e.g. cultural/religious differences, information-based decision-making
Professional attitude towards procedures performed for non-medical reasons, e.g. (female) genital mutilation
Differing mother languages and cultural backgrounds between client/patient and professional, need for interpreting
Plain language
Vulnerable client groups
Life situations of clients and patients in vulnerable positions and working with them
Empowering clients/patients, partnership
Groups with special support needs
- people with dementia
- mental health and intoxicant abuse customers
- people with developmental disabilities
Effects of harmful addiction on health, intervening in addiction while supporting the client/patient
Continuity of care
Special questions related to the safety of older clients/patients, such as service pathway, flow of information and societal digitalisation
Children and youths
Client and patient rights
Client and patient rights, autonomy and the requirements for restricting autonomy
Preventive operating methods
Advance decision documents – living wills
Learning outcome
interaction
Assessing a client/patient’s capacity to understand, absorb information and make decisions
Offering explanations, advice and support in a way that reflects the client/patient’s level of understanding and needs
Supporting the client/patient’s resources
Clarity, efficiency, considering the other party, reliability, considering fear
- listening, responding to questions
- empathy and sympathy
- interaction skills – utilising language and non-verbal communication
- skills to adjust communication individually based on factors such as sensory disabilities or limited language skills
- impaired hearing, vision or speech production, aphasia
- reduced cognitive capacity or learning ability
- plain language
Clear use of speech, writing and electronic communications that takes the receiving party into account (including in medical reports) in the following situations:
- conveying bad news to a patient or their friends or family
- conveying news of a death
- sensitive issues: use of alcohol, tobacco, obesity or reproductive health
Skills to assess the client/patient’s ability to decide on their care and knowing how to act when the client/patient’s ability to make decisions is temporarily or permanently impaired
Respectful and human encounters – including in situations where the client/patient is a risk to themselves or others (psychosis, dementia, alcohol, narcotics, etc.)
Harmful events and safety events, complaints
Encouragement towards filing reports, support of filing reports
Open discussion, apologies
Recognising abuse, violence and neglect
Appropriate operating methods in the care of persons using intoxicants, engaging in self-harm or under risk of suicide
Content
Infection prevention and control
Infection
Hospital-acquired infection
- cross-infection
Treatment-related infections
- health care-associated infections (HCAI)
Microbiology
Antibiotic resistance in microbes
- antimicrobial resistance (AMR)
Multidrug-resistant bacteria
- e.g. MRSA = methicillin-resistant Staphylococcus aureus
Transmission (infection from one unit to another)
Learning outcome
Hand hygiene
Aseptic techniques
- aseptic working methods
- aseptic conscience
Normal precautions
Contact, droplet, airborne and protective precautions
Employee vaccinations
Content
Surgical safety
Operation room checklist/other checklists
Instructions/guidelines
Onboarding instructions
Teamwork
Communication
Infections of the site of surgery/procedure, surgical/procedural errors
Confirmation processes
Verification processes
Learning outcome
Identification of patient at different stages
Checklists
Surgical team’s checklist
- before anaesthesia
- before surgery
- after surgery
Correct use and storage of sharp instruments to prevent incidents such as blood accidents.
Safe teamwork and safe communication
Ensuring continuity of care when transferring the burden of care from one party to another when changing wards or shifts
Data transfer, including between electronic systems
Content
Medication safety
- sales permit procedures, evaluation of efficacy, safety and quality, register of adverse reactions
Medication safety
- Humane work by those administering pharmacological treatment
- Accuracy and efficiency of pharmacological treatment process
Side effects, adverse effects, adverse reactions, abnormalities, errors, harmful events, harmful pharmacological events, medication error, and the prescription, administering and monitoring of medication
Abnormalities
- the most significant risk factor endangering patient safety in healthcare
- a mistake may even lead to death
- something is done wrong or something is not done
- unnoticed interactions and overlap
- providing the patient with the wrong medication
- providing the medication to the wrong patient
- forgetting to provide medication
- abnormality in logging, patient guidance or effect monitoring
Learning outcome
Prescription of medication
Distribution of medication
Logging prescriptions and changes to prescriptions
The 10 Cs of pharmacological treatment processes
- correct patient
- correct medication
- correct dosage
- correct time of administration
- correct route of administration
- correct purpose of use
- correct preparation of medication
- correct documentation
- correct guidance
- correct monitoring and evaluation of effects
Safeguards of the pharmacological treatment process (e.g. double check)
Pharmacological treatment plan of the organisation/unit
- operating models, selection of medication, ensuring safety, guidelines, etc.
Ensuring pharmacological treatment competences in working life
- medication safety training
- necessary permits and evidence
- fluid therapy guidelines
- blood product guidelines
Content and learning outcomes
Device safety
Cooperation between humans and technology
Medical devices
Software
Standards and regulations on medical devices
Professional user
Guidance of client/patient in using healthcare and wellbeing technology
Ensuring the functionality and user safety of devices
Safe use of radiation
Data systems
Digital technology
Digital technology, remote consultation
Remote consultation (phone, video, chat)
Remote and digital services – client/patient’s right to choose
Data protection and security in the social welfare and healthcare systems
Obligation of secrecy and confidentiality
Data protection, data security, information security, confidentiality
Access control
Content and learning outcomes
Safety of facilities
- accessibility
- stairs
- windows
- order of rooms for monitoring
- sharp objects
- (other people)
Chemical safety
Fire safety
Environmental safety
- prevention of infectious diseases
Waste management
- hazardous waste
Work safety – safety plans and procedures for reporting dangerous situations
Employee background checks
Support material for use in education
Training material on all WHO topics (topics 1–11 in the document) is available free of charge through the Finnish Centre for Client and Patient Safety. A PowerPoint presentation and instruction video is available regarding the topics.
Similar material is not yet available for the device safety and operating environment safety topics, which were decided to be added as separate topics to this education evaluation material. The links below provide more information on these topics, as well.
WHO:n Patient Safety Curriculum Guide
Multiprofessional Edition
Patient safety curriculum guide: multi-professional edition (who.int)
DIRECT LINK: Who1-17 FirstPages
Global Patient Safety Action Plan 2021-2030
Global Patient Safety Action Plan 2021-2030 (who.int)
National Patient Safety Education Framework
The Australian Council for Safety and Quality in Health Care
National Patient Safety Education Framework (safetyandquality.gov.au)
National Model Clinical Governance Framework
Published by the Australian Commission on Safety and Quality in Health Care
National Model Clinical Governance Framework | Australian Commission on Safety and Quality in Health Care
The Safety Competencies Enhancing Patient Safety Across the Health Professions Second Edition
The Safety Competencies 2ND EDITION Enhancing Patient Safety Across the Health Professions (healthcareexcellence.ca)
Final report
Embedding patient safety in education & training
Netherlands Association of Hospitals, the Society of Medical Specialists, the Netherlands Federation of University Medical Centres, and the Netherlands Association of Nurses & Caregivers
Final-report-embedding-patientsafety-training.pdf (vmszorg.nl)
Curriculum Guidance for Delivering the NHS Patient Safety Syllabus Training in Patient Safety
Curriculum Guidance for DelC`x`zczzurriculum Guidance Cursacsacriculum Guidance for xx x x xx x x xc cxxiverisddsfdssng the NHS Patient Safety SyllabusNHS Patient Safety Syllabusivering the NHS Patient Safety Syllabus (hee.nhs.uk)
NHS Patient Safety Syllabus
NHS Patient Safety Syllabus.pdf (hee.nhs.uk)
Scottish Patient Safety Programme (SPSP)
Scottish Patient Safety Programme (SPSP) | ihub | Health and social care improvement in Scotland – Scottish Patient Safety Programme (SPSP)