Nearly two decades after the Institute of Medicine published its landmark report on mistakes in medicine, “To Err Is Human,” the U.S. has its first PhD program in healthcare quality and safety.
The program, at Northwestern Medicine in Chicago, trains senior and mid-career clinicians and others working in healthcare. Professionals from outside the field, such as engineers and change management specialists, teach.
“How will this ever get fixed if we don't train a work force to do it?” Donna Woods, director of the graduate programs in health care quality and patient safety at Northwestern University Feinberg School of Medicine, said in a press release, referring to medical errors in the U.S. A study published in May suggested medical error was the third-highest cause of death in the U.S., responsible for more than 250,000 deaths annually.
That number was hotly disputed, with some doctors arguing that the estimate was inflated and sensationalized. Nevertheless, there is widespread agreement that medical errors must be taken seriously and prevented, not just for a patient's sakes but for providers' bottom lines.
While the 1999 IOM report gave birth to the modern patient-safety movement, the proliferation of value-based purchasing programs among government and commercial payers alike has also driven providers to scrutinize care processes and constantly assess quality and safety.
In 2012, 184 executives at not-for-profit healthcare organizations managed quality and safety. The following year, that number had risen to 306, according to Modern Healthcare's database of executive compensation at not-for-profit healthcare organizations.
The curriculum tackles skills like teamwork, communication and physical and cognitive ergonomics. The idea is that experts who are not steeped in healthcare norms teach students how to identify flaws in existing processes -- and give them the research skills to fix those problems or redesign systems in evidence-based ways.
Take, for example, the EpiPen. When physicians are in a crisis, they sometimes stick themselves with the injector instead of the patient. Students had to examine the EpiPen's design to figure out why -- and how to address the issue.
“We need an army of experts who need to know how to address this. The medical field does not have the skills to do it,” Woods added.
Other schools have quality-and-safety training programs as well, although not at the PhD level. The George Washington University, the University of Alabama at Birmingham, and the University of Toronto, for instance, all offer master's programs.
The Institute for Healthcare Improvement has the Open School, which combines online education, guided projects, and community and chapter networks to build “core skills in improvement, safety, system design, and leadership,” according to its website. It has 824 chapters in 85 countries, and more than 80,000 students and residents have earned its basic certificate in quality and safety.
Cindy Barnard, vice president of quality for Northwestern Memorial Healthcare, was the first graduate of Northwestern's PhD program, in September.