HSC poster5

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Al-Braheem A [1] , AlRasheedi S [1] , Borahmah A [1] , Elamir H [3] , Jacob S [1] , Bouhaimed M [1,2] [1] Department of Community Medicine and Behavioural Sciences, Kuwait University Faculty of Medicine. [2] Department of Surgery, Kuwait University Faculty of Medicine. [3] Department of Quality and Accreditation, Mubarak Al-Kabeer Hospital, MOH Is The Accreditation Program Enough To Ensure Patient Safety? A Students' Reflection On A Patient Safety Required Area Background: Learning consists of cognitive, emotional and social dimensions. In medical education, the cognitive dimension is usually measured through assessments of performance (Fig 1), while the social and emotional dimensions are more challenging to capture. Developing a protocol containing informed consent completion as a part of the pre-intervention patient’s verification is a patient safety required area mandated by The National Accreditation program to ensure performance of correct procedure at correct body site. Completion of the consent is required by medical records regulations as well. The informed consent is not merely a form but an internationally accepted way of communicating verified information about the patient, the procedure and the surgeon through an actual process that entails a doctor-patient interaction (Fig 2). The objective of this case report is to focus on the use of informed consent forms as an educational tool during the elective course “Patient Safety: Better Knowledge for Safer Care”. Case Summary: The Burton’s approach to reflection (Fig 3) with the 3 core questions of: What? So What? Now What? was used during the assessment of masked non-identifiable consent forms retrospectively reviewed as part of a hospital based audit. The WHAT? component revealed: Total of 41 masked informed consents were used during this ethical analysis to identify the deviation from the standard of care and the potential ethical and safety issues relevant to the review. The findings were as follows: Conclusion: The Burton’s reflection approach was successfully used as a tool in teaching a clinical ethics course on patient safety. Contacts: For further information, please contact: Dr. Manal Bouhaimed Email: manal_q8 @hsc.edu.kw Tel(office): 24636532 Acknowledgement: We would like to acknowledge the assistance provided by Quality Nurses: Abeer G. Dossokey, Amal T. Mohamed, Asila A. Alrasheedi, Lea Martinez & Rinto Francis. Remembering Understanding Applying Analyzing Evaluating Creating 1. Bloom, Benjamin (ed.). Taxonomy of Education al Objectives. Handbook I: Cognitive Domain. David McKay Company, Inc. New York: 1956. http://pcs2ndgrade.pbworks.com/w/page/46897760/Revised%20Bloom's%20Taxonomy Fig 1: Bloom’s Taxonomy (Revised) Can the student distinguish between different parts? Appraise, compare, contrast, criticize, differentiate, discriminate, distinguish, examine, experiment, question, test Define, duplicate, list, memorize, recall, repeat, state Can the student recall or remember the information? Can the student explain ideas or concepts? Can the student use information in a new way? Classify, describe, discuss, explain, identify, locate, recognize, report, select, translate, paraphrase Choose, demonstrate, dramatize, employ, illustrate, interpret, operate, schedule, sketch, solve, use, write Can the student justify a stand or decision? Appraise, argue, defend, select, support, value, evaluate Can the student create a new product or point of view? Assemble, construct, create, design, develop, formulate, write The SO WHAT? component revealed the students’ uncomfortable feelings and thoughts especially at a time when there is a national accreditation program in the country. The NOW WHAT? component showed a clear commitment “to do the right thing” and “first do no harm”. The students found two different versions of Consent Form that are used in MOH hospitals, with critical findings related to the contents of both (Fig 5). Patient’s Full name (missing in 9.5%) Patient’s Signature (missing in 4.9%) (present but in a different language than the one patient use in 7.3%) Procedure: Name, site, Side, Level (missing in 12.2%) Abbreviations used (in 19.5%) Doctor’s Name (present in 100%) Date of Birth (missing in 100%) Medical Record Number (missing in 9.8%) Doctor’s Signature (missing in 12.2%) Fig 4: Findings of Consent Form Audit Fig 5: Two versions of Consent Form DO IT. What? What happened? What were the results? Now What? What will I do differently next time? So What? What do these results imply? How did I influence the outcome? Fig 3: The Burton’s approach to reflection Fig 2: Doctor-patient interaction

Transcript of HSC poster5

Al-Braheem A [1], AlRasheedi S [1], Borahmah A [1], Elamir H [3], Jacob S [1], Bouhaimed M [1,2]

[1] Department of Community Medicine and Behavioural Sciences, Kuwait University Faculty of Medicine.[2] Department of Surgery, Kuwait University Faculty of Medicine.

[3] Department of Quality and Accreditation, Mubarak Al-Kabeer Hospital, MOH

Is The Accreditation Program Enough To Ensure Patient Safety?A Students' Reflection On A Patient Safety Required Area

Background:

Learning consists of cognitive, emotional and social dimensions. In medical education, the cognitive dimension is usually measured through assessments of performance (Fig 1), while the social and emotional dimensions are more challenging to capture. Developing a protocol containing informed consent completion as a part of the pre-intervention patient’s verification is a patient safety required area mandated by The National Accreditation program to ensure performance of correct procedure at correct body site. Completion of the consent is required by medical records regulations as well. The informed consent is not merely a form but an internationally accepted way of communicating verified information about the patient, the procedure and the surgeon through an actual process that entails a doctor-patient interaction (Fig 2). The objective of this case report is to focus on the use of informed consent forms as an educational tool during the elective course “Patient Safety: Better Knowledge for Safer Care”.

Case Summary:

The Burton’s approach to reflection (Fig 3) with the 3 core questions of: What? So What? Now What? was used during the assessment of masked non-identifiable consent forms retrospectively reviewed as part of a hospital based audit. The WHAT? component revealed: Total of 41 masked informed consents were used during this ethical analysis to identify the deviation from the standard of care and the potential ethical and safety issues relevant to the review. The findings were as follows:

Conclusion:The Burton’s reflection approach was successfully used as a tool in teaching a clinical ethics course on patient safety.

Contacts:For further information, please contact:Dr. Manal BouhaimedEmail: manal_q8 @hsc.edu.kw Tel(office): 24636532

Acknowledgement:We would like to acknowledge the assistance provided by Quality Nurses: Abeer G. Dossokey, Amal T. Mohamed, Asila A. Alrasheedi, Lea Martinez & Rinto Francis.

Remembering

Understanding

Applying

Analyzing

Evaluating

Creating

1. Bloom, Benjamin (ed.). Taxonomy of Education al Objectives. Handbook I: Cognitive Domain. David McKay Company, Inc. New York: 1956.http://pcs2ndgrade.pbworks.com/w/page/46897760/Revised%20Bloom's%20Taxonomy

Fig 1: Bloom’s Taxonomy (Revised)

Can the student distinguishbetween di�erent parts?

Appraise, compare, contrast, criticize,di�erentiate, discriminate, distinguish,

examine, experiment, question, test

De�ne, duplicate, list, memorize,recall, repeat, state

Can the student recall orremember the information?

Can the student explain ideas orconcepts?

Can the student use informationin a new way?

Classify, describe, discuss, explain,identify, locate, recognize, report,

select, translate, paraphrase

Choose, demonstrate, dramatize,employ, illustrate, interpret, operate,

schedule, sketch, solve, use, write

Can the student justify a standor decision?

Appraise, argue, defend, select,support, value, evaluate

Can the student create a newproduct or point of view?

Assemble, construct, create, design,develop, formulate, write

The SO WHAT? component revealed the students’ uncomfortable feelings and thoughts especially at a time when there is a national accreditation program in the country. The NOW WHAT? component showed a clear commitment “to do the right thing” and “first do no harm”.

The students found two different versions of Consent Form that are used in MOH hospitals, with critical findings related to the contents of both (Fig 5).

Patient’s Full name(missing in 9.5%)

Patient’s Signature(missing in 4.9%)(present but in a different languagethan the one patient use in 7.3%)

Procedure: Name,site, Side, Level

(missing in 12.2%)

Abbreviations used(in 19.5%)

Doctor’s Name(present in 100%)

Date of Birth(missing in 100%)

Medical Record Number(missing in 9.8%)

Doctor’s Signature(missing in 12.2%)

Fig 4: Findings of Consent Form Audit

Fig 5: Two versions of Consent Form

DO IT.

What?What happened?

What were theresults?

Now What?What will I

do differentlynext time?

So What?What do these results imply?

How did I influence theoutcome?

Fig 3: The Burton’s approach to reflection

Fig 2: Doctor-patient interaction