113 - Implementing a Safety Curriculum for Critical Care Advanced Practice Providers

Publication Number: 113.5403

Jamie Cargill, Baylor College of Medicine, Houston, TX, United States; Sakina J. Attaar, Baylor College of Medicine, Houston, TX, United States; Asma Razavi, Texas Children's Hospital, Houston, TX, United States; Aarti Bavare, Baylor College of Medicine, Houston, TX, United States

Background: Patient safety science has expanded over the last decade, becoming a key component to providing high quality care. The Pediatric Intensive Care Unit is a complex environment where safety events can occur or the sequelae of severe safety events are managed. As the science develops, it has become imperative to create a safety culture mindset in all team members that encourages the team to assess safety concerns, errors, and events to uncover systemic solutions and strategies for prevention. We built a curriculum for critical care advanced practice providers (APPs) with a framework of transformative learning theory to enhance knowledge of safety concepts and practice the application of these concepts, including just culture, the limitation of bias, and event debriefing.

Objective: Teach the concepts of safety science to critical care APPs and apply these concepts to the understanding and practice of patient safety.

Design/Methods: We designed a curriculum on principles of transformative learning for APPs at all levels of experience. Learners received articles and videos about safety science to review in advance. The curriculum was structured as a workshop divided into three hour-long sessions. The first hour was a root cause analysis (RCA), with participants assigned to three teams with each team given a different case and tasked with asking better questions to uncover systemic issues and teach the concept of just culture. In the second hour, the group was asked to compete in a game-style question and answer session that included review of key safety concepts from their pre-reading. In the final hour, participants completed a case-based escape room activity with application of the concepts from the first and second sessions, including practicing changed behavior in approaching safety event review with a just mindset. Participants completed pre- and post- assessments of their comfort with safety topics.

Results: Fourteen APPs enrolled, with all completing the pre-assessment and eleven completing the post-assessment. When asked to rate their comfort with evaluating safety events before and after the workshop, their rating improved from 57% to 83%, and comfort in participating in an RCA improved from 46% to 84%. All participants were asked to rate whether the sessions tested their ability to ask better questions and function as an effective team member, with all participants providing a rating of 80% or higher.

Conclusion(s): A safety curriculum can help develop a safety mindset in APPs, improve their comfort with safety topics, and contribute to the creation of a safety culture in Pediatric Critical Care Units.