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Ideas and Opinions |

Science-Based Training in Patient Safety and Quality

Peter J. Pronovost, MD, PhD; and Myron L. Weisfeldt, MD
[+] Article, Author, and Disclosure Information

From Armstrong Institute for Patient Safety and Quality, Johns Hopkins University School of Medicine, and Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.

Acknowledgment: The authors thank Christine G. Holzmueller, BLA, for her assistance in editing the manuscript.

Potential Conflicts of Interest: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M11-2717.

Requests for Single Reprints: Peter J. Pronovost, MD, PhD, 1909 Thames Street, 2nd Floor, Baltimore, MD 21231; e-mail, ppronovo@jhmi.edu.

Current Author Addresses: Dr. Pronovost: 1909 Thames Street, 2nd Floor, Baltimore, MD 21231.

Dr. Weisfeldt: 1830 East Monument Street, Suite 9026, Baltimore, MD 21287.

Author Contributions: Conception and design: P.J. Pronovost, M.L. Weisfeldt.

Drafting of the article: P.J. Pronovost, M.L. Weisfeldt.

Critical revision of the article for important intellectual content: P.J. Pronovost, M.L. Weisfeldt.

Final approval of the article: P.J. Pronovost, M.L. Weisfeldt.

Administrative, technical, or logistic support: P.J. Pronovost.

Ann Intern Med. 2012;157(2):141-143. doi:10.7326/0003-4819-157-2-201207170-00457
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The U.S. government's investment in training researchers and funding research projects has produced many medical advances. However, many patients still suffer preventable errors and harms and fail to receive recommended therapies. This commentary discusses the minimal investment in the science of patient safety and quality improvement and argues that more patient safety researchers are needed to rigorously design, implement, evaluate, and spread interventions to reduce preventable harm.

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Science-based training in patient safety and quality
Posted on September 18, 2012
Douglas Paull, Bradley V. Watts, MD, MPH, Robin R. Hemphill, MD, MPH
VA National Center for Patient Safety, Ann Arbor
Conflict of Interest: None Declared

We read the article by Pronovost and Weisfeldt (1) with interest. We are happy to report that the Veterans Health Administration (VHA) has heeded their ‘call to arms’ to include patient safety and quality improvement in graduate medical education. The VHA Office of Academic Affiliations (OAA) and the National Center for Patient Safety (NCPS) have offered an Advanced Fellowship in Patient Safety since 2005. The graduates of this inter-professional Fellowship have included 16 with master degrees in public health or hospital administration, 15 physicians, 6 nurses, 4 with doctoral degrees (anthropology, sociology, computer science, organizational psychology), 3 pharmacists, and 1 clinical psychologist. The Fellowship is a one year program, in residence, at one of 7 university-affiliated VHA Medical Centers across the country, with the VHA NCPS serving as the academic hub. The curriculum includes a weekly two-way-interactive-video (TWIV) hosted by NCPS Faculty, face-to-face meetings, and local patient safety and quality improvement projects and activities mentored by local Faculty. Curricular domains include high reliability organizations; systems theory and understanding error; patient safety culture; teamwork and communication; reporting and disclosure of medical errors; change models; transformational leadership; information technology; medication errors, infection, and suicide prevention; and simulation-based teaching.Fellows have completed over 200 patient safety and quality improvement projects and published 58 articles in peer-reviewed journals. Graduates have gone on to positions in research, education, and quality and safety both within the VHA and in other healthcare organizations.Building on the success of the Patient Safety Fellowship, VHA NCPS and OAA have collaborated with The Dartmouth Institute in developing a “Chief Resident in Quality and Safety” (CRQS) Program. The Program currently includes 20 Residency Sites at university-affiliated VHA Medical Centers with positions in Medicine and Surgery. The Program will be expanding next year both in number of sites and breadth of specialties. The VHA Patient Safety Fellowship and the CRQS Program are a start in fulfilling the vision shared by Pronovost and Weisfeldt that “health care needs appropriately trained young clinicians and researchers to lead the way toward improving patient safety . . .” (1).


1. Pronovost, P.J., Weisfeldt, M.L. Science-based training in patient safety and quality. Ann Int Med 2012;157:141-143. [PMID 22688840]

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