Operational Quality and Safety

Analyze the evolving definitions of quality and safety in health care, and how they can be measured and improved. Explore the impact of culture, human factors, and system theory on safety science, and how detection methods affect error impact. Special focus areas include:

• Procedural safety
• Medication safety
• Ambulatory safety
• Cognitive bias

Informatics

Examine the role of informatics in health care improvement. Students will explore the digital infrastructure for capturing and organizing data, including user interfaces utilized by patients and providers. The focus is on how to collect and display data in the context of real improvement work. Other topics include health care privacy issues and the design of:

• Clinical databases
• Electronic health records
• Patient portals

Leadership

Gain an overview of relevant safety and quality leadership concepts, as well as those required to drive meaningful change. Students will learn to initiate action in the complex health care environment where stakeholders have varying and often competing needs. Foundational concepts include:

• Change management
• Negotiation and consensus building
• Making a financial case for quality and safety
• Managing teams for improvement

Quantitative Approaches

Learn to assess outcomes specific to ongoing quality improvement (QI) research using statistical processes. Students will examine study design—including measurement, bias, and sample sizes—and gain the skills to:

• Apply quantitative methods to QI work
• Analyze simple data and present findings
• Discuss and weigh general institutional review board (IRB) issues

Risk

Obtain an overview and evolution of malpractice, along with strategies to promote safety and error disclosure. Students will explore innovations and interventions in different areas of risk, including:

• Diagnostic process
• Communication failures
• Procedural safety
• Medication safety

Capstone

Working closely with a faculty mentor, each student will utilize the tools, strategies, and methods gained from the case studies and coursework, aiming to develop evidence-based solutions for health care delivery. The selected challenge may be driven by a need in:
•    Quality
•    Safety
•    Informatics
•    Risk Management

Examples of past capstone projects include:
•    Improving Initial Hospitalist-Patient Communication Experience Through Standardized Information Cards
•    Widespread Implementation of a Structured Handoff Across Boston Children’s Hospital
•    Improving the Patient Experience at Mount Auburn Hospital by Focusing on Communication about Medications

Learning Model

Offered in full-time (one year) and part-time (two years) options, this quality and safety program features a unique three-tiered academic model:

•Theoretical concepts that establish the foundational knowledge and skills required for quality and safety
•The opportunity to work one-on-one with a faculty mentor to apply best practices in a health care setting
•The capstone experience, in which students design an intervention intended to make an improvement to a problem they have identified and analyzed

The capstone project culminates in a data-driven report demonstrating an understanding of the concepts, applying them to real-life situations, and explaining how their intervention addressed those issues. Working with a faculty mentor, each student will apply the tools, strategies, and methods gained from the case studies and coursework to develop a solution to an evidence-based problem in health care delivery. Upon graduation, students will be qualified to serve as leaders at institutions of any size.

Safety Intensive

This course provides students with a foundation in patient safety. Beginning with the question, “Are we any safer than 20 years ago?,” students explore the state of health care today. Fundamental concepts in safety are examined, including the interplay of culture, human factors, and system theory as critical components of safety science. The approaches to adverse events are reviewed along with how detection methods can alter the impact of the error.

Special areas of focus are discussed, including procedural safety, medication safety, ambulatory safety, and cognitive bias.

Quality and Systems

After providing historical context for safety and quality, this course builds on prerequisite learning modules to employ critical quality improvement (QI) tools and emphasizes the importance of data. This course focuses on how to collect and display data, and shares examples of how data can change care at every level of the health care system. Students complete a short primer on systems engineering and two workshops on design and behavioral change.

Quantitative Approach to QI

This course teaches students to assess outcomes for ongoing QI research using statistics. Students will learn various aspects of study design, such as measurement, bias, and sample sizes, and will develop the skills needed to apply quantitative methods to QI work, analyze data, present findings, and discuss institutional review board (IRB) issues.

Longitudinal Seminars (I & II)

The fall seminar will focus on reviewing the framework for project work. Students will define a problem within an organization using QI tools, such as mapping, fishbone diagrams, and key driver diagrams, as well as input from local stakeholders. Interventions will be proposed by the end of the seminar, along with a projected implementation plan. Students will be asked to reflect on the process of moving from problem to design and will conclude with a poster session they will share their work-in-progress and receive feedback from peers.

In the spring seminar, students will begin with the implementation plan that they developed in Seminar I. Students will reflect on the process of implementation as they explore effective approaches to navigating change in a health care unit. This seminar will conclude with a capstone symposium during which candidates will briefly present both their projects and their reflections as learners.

Health Care Finance and Value

This course examines the concepts of value and cost within the health care delivery system. Students will explore the evolving definitions of value from the perspectives of different stakeholders and their motivations for change. This course also addresses the varying definitions of the costs and impacts on value.

Risk Innovation

This course presents an overview of malpractice and evolutions in the field, along with strategies for promoting safety and error disclosure. Students explore innovations and interventions in different areas of risk, including the diagnostic process, communication failures, procedural safety, and medication safety.

Bioinformatics and Clinical Quality

This course serves as a primer on the role of informatics in health care improvement. Students will learn about the digital infrastructure that captures and organizes data, as well as the user interfaces for patients and providers. Topics will include the design of clinical databases, electronic health records, patient portals, and health care privacy issues.

Patient Engagement in QIPS

This course highlights the patient interface with the health care system, and provides a unique perspective for health care professionals engaged in safety and quality improvement. Engaging patients in the improvement process is critical for success—from the reporting of events to intervention design and health care provider training.

This course takes a deep dive into multiple areas, including the role of patient-family advisory councils, the voice of patients in event reporting, models to partner with patients in improvement work, and effective organizational structures to respond to patient concerns. It features a combination of traditional and innovative learning approaches as well as small group discussions.

Applied Quality in Health Care Settings

This course focuses on changes and best practices to combat known risks in health care today. These include approaches to hospital-acquired conditions, as well as systematic interventions to recognize and minimize harm in both hospital and ambulatory settings. The course explores strategies to support a culture of safety, including spreading knowledge, teamwork training, and managing unprofessional behavior.

The advanced content discusses system interventions to improve the quality of care. Topics such as value, the patient experience, and health care disparities as measures of quality are explored.

Leadership and Teamwork

The process of change in health care environments is not simple. Systems are complex, and stakeholders have different individual needs. This course provides an overview of the leadership concepts that are most relevant to safety and quality and the cultures that leaders need to establish. These include foundational concepts in change management, negotiation and consensus building, making a financial case for quality and safety, and managing teams for improvement.