Safety course prepares students for practiceby Michael BakerPublic Relations While the MUSC Medical Center continues to refine its systems to improve patient safety, the university addressed the issue with the addition of a new elective course, “Reducing Medical Errors and Malpractice Risk,” offered to fourth-year medical students. Course instructors Gautham Suresh, M.D., and Mike Southgate, M.D., hope the course will help students gain a greater awareness and understanding of patient safety. “Our goal is to create safety-minded doctors,” Suresh said. “We want students to realize that medical errors are a problem and that making health care safer for patients should be an important point of routine clinical work.” “We want students to come away from the class mindful that errors will occur in health care,” Southgate agreed, “so they’ll need to be mindful of error-producing situations, looking for potential errors before they occur.” Although the doctors’ sentiments echo each other, Suresh and Southgate approached the new course from different backgrounds. Suresh had conducted prior research on medical errors, working with neonatal intensive care units across the country to improve patient safety and decrease errors. Conversely, Southgate conceived the idea of a patient safety course as a result of more than a decade of administrative experience as the medical director of the MUSC Neonatal Intensive Care Unit. Though both physicians are neonatologists, the principles and topics covered in the course seminars span all areas of health care. “Dr. Southgate came up with the idea and suggested it when I was interviewing for a position at MUSC,” Suresh recalled. Southgate’s idea intrigued him enough to inquire about collaborating. “During his interview, I mentioned that I wanted to develop a course to address medical errors and patient safety,” Southgate said. “His first response was ‘Wait, what are you doing?’ and then ‘Can I help?’ It wasn’t until Gautham arrived that things really started moving along.” When Suresh accepted a position at MUSC in 2003, the two men set to work developing the course. The curriculum incorporates a range of subjects related to patient safety, including the history and evolution of the safety movement and what Suresh called “the nitty-gritty of how to prevent specific errors.” To address such specifics, students will participate in interactive, case-based discussions. The students will analyze real-life medical cases to determine how to prevent and handle similar situations. “First, we’ll discuss whether an error was made in each case,” Suresh explained. “If so, we’ll examine why the error occurred, whether the error is common, and how it can be prevented.” Southgate asserted that the subject matter warranted more than a typical lecture-based curriculum. “Lectures are boring, and we don’t want students to be passive learners on the important issues,” he said. “We’ll also bring in attorneys from the hospital and from outside firms to let students discuss the legal ramifications of medical errors.” Other course topics include methods of error disclosure to patients and families, and the ethics of patient safety. Perhaps the most important issue that Suresh and Southgate will address is the idea of improving systems, not criticizing people who make mistakes. “Our focus is to take the blame off the individual,” Suresh said. “The important thing is for students to realize that errors usually aren’t a problem of the individual problem, and firing the person likely won’t prevent the problem from recurring,” Southgate explained. “You have to change the system in which they work to reduce the likelihood of a repeat occurrence.” The counterproductive who’s-to-blame attitude could be at fault for what Suresh deemed a lack of overall awareness of patient safety issues within the medical community. “In some medical climates, if a nurse or physician reports an error, he or she is likely to be castigated, not appreciated. So errors go unreported,” he said. “We need to learn from others’ errors, and although awareness of patient safety has increased, we still don’t have that kind of sharing in health care.” “I think most people operate under the assumption that getting rid of a few bad apples will make the problem go away,” Southgate added. “They need to realize that patient safety is a team effort. It’s not a matter of ‘fix that person,’ but rather ‘fix the system’ that made the mistake.” The course also acknowledges safety improvements from other high-risk industries, such as aviation and nuclear power. Suresh described the aviation industry's non-punitive system of reporting problems, learning from them and disseminating safety recommendations. Although one would assume that patient safety classes would be commonplace within the health care educational system, MUSC joins a select few universities across the nation with such a course. “MUSC appears to be ahead of the curve when educating medical students about patient safety, but this is only a starting point, the embryonic stage,” Southgate said. “We’re using a catch-them-young strategy with our students,” Suresh added. “If we train them to deal with these issues as students, they’ll have a correct approach to safety as practicing doctors.” Suresh and Southgate recognized the following for their support and
encouragement during the course's planning stage: MUH Medical Director
John Heffner, M.D.; Director of Quality and Patient Safety Rosemary Ellis,
R.N.; Amy Blue, Ph.D., assistant dean for curriculum and evaluation in
the College of Medicine; Dilip Purohit, M.D., director of neonatology;
and David Annibale, M.D., professor of pediatrics.
Friday, Sept. 17, 2004
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