The outcomes card. Development of a systems-based practice educational tool.

Area of Science:

• Medical Education
• Patient Safety
• Healthcare Systems

Background:

• Accreditation Council for Graduate Medical Education mandates competence in systems-based practice (SBP).
• Understanding complex healthcare systems and their impact on care delivery is crucial.
• Patient safety initiatives provide a practical framework for learning about system interactions.

Purpose of the Study:

• To develop and evaluate an educational tool, the Outcomes Card (OC), for reinforcing core concepts of systems-based practice (SBP).
• To assess the feasibility and reliability of the OC in a clinical setting.

Main Methods:

• A pilot study was conducted at an Urgent Care Center within the Louis Stokes Cleveland Department of Veterans Affairs Medical Center.
• Residents participated in patient safety didactic sessions and analyzed self-identified clinical cases using the OC.
• The OC captured case descriptions, event types, error types, systems involved, and system failures.

Main Results:

• Two independent reviewers analyzed 98 completed OCs from 60 trainee rotations, achieving an 81.7% return rate.
• Excellent interrater reliability was found for error types (kappa=0.88-0.95) and good reliability for system identification (kappa=0.66-0.68).
• Resident self-assessment surveys indicated improved patient safety knowledge and positive attitudes toward the curriculum.

Conclusions:

• The Outcomes Card (OC) is a feasible and reliable educational tool.
• The OC effectively enhances resident competence in systems-based practice (SBP).
• This tool supports the integration of patient safety principles into medical education.