Karin Pukk Hrenstam M'D' PhD

1

Education in Quality Improvement in
Sweden-preparing future health care
professionals

• Karin Pukk Härenstam M.D. PhD
• Medical Management Centre, Karolinska Institute
  and Danderyds Hospital Stockholm
• Slides by Michael Bergström SALAR and Karin Pukk
  Härenstam

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Health Social Care in Sweden

• Cover 9 millions in 1700 km x 400 km (20/sq km)
• 18 County Councils 3 Regions (HC)
• 290 Municipalities (HC and SC)
• Public Private (small) sector
• Equal care and availability for all
• 6 medical universities and manynursing
  universities
• National Board of Health and Welfare
• Swedish Assocation of Local Authoritiesand
  Regions

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quality improvement

• The combined and unceasing efforts of everyone
  health care professionals, patients and their
  families, researchers, payers, planners,
  educators to make changes that will lead to
  better patient outcome, better system
  performance, and better professional development.

Batalden P, Davidoff F. What isquality
improvement and how can it transform
healthcare? Qual.Saf.Health Care 2007162-3
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Every system is perfectly designed to get the
results it gets.
Paul Batalden
also the educational systems
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What we have to learn to do, we learn by doing

• Aristotle
• (long time ago)

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Towards a breakthrough in Quality Improvement
education?
Students
Teaching teachers
Training staff
Research
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Towards a breakthrough in Quality Improvement
education?
Elective in patient safety
Interprofessional elective Building the future
health care
Exerience based learning for QI facilitators
OI and safety for Residents
Masters students
Webcourse in Improvement
Group dynamics and leadership
15 PhD students 5 post docs
University collaborative
Distance course Learning and Improvement
knowledge
Local breakthrough projects
Teamwork and QI at teaching ward
Medical management Centre KI
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Towards a breakthrough in Quality Improvement
education?
Elective in patient safety
Interprofessional elective Building the future
health care
Exerience based learning for QI facilitators
OI and safety for Residents
Masters students
Webcourse in Improvement
Group dynamics and leadership
15 PhD students 5 post docs
University collaborative
Distance course Learning and Improvement
knowledge
Local breakthrough projects
Teamwork and QI at teaching ward
Medical management Centre KI
9
University Collaboration on Improvement
Knowledge2002-2004-2008

• Initiated by SALAR, Swedish Nursing Society and
  the Karolinska Institute
• To put improvement knowledge into health care
  professionals undergraduate education
• To support faculty development
• To create an arena for collaboration between
  existing improvement centers in health care
  organisations and teachers at nursing and medical
  universities

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ParticipantsMedical and Nursing Universities
and Health Care Organisations (from north to
south)

• University of Umeå and The County Council of
  Västerbotten
• The Karolinska Institute and The County Council
  of Stockholm and Municipality of Gotland
• University of Linköping and The County Council of
  Östergötland
• The Health University of Jönköping and The County
  Council of Jönköping

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Some participants..
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The process

• Based on the teachers needs to learn
  Collaborative Meetings at the Universities on
  rotation
• Local work and challenges
• Sharing experiences
• Working questions
• Support of local activites and developing courses
  and assignments

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Working questions..

• Improvement knowledge What is it? Terminology?
  Language?
• How to design courses and assignments?
• How to change attitudes, bringing more colleagues
  along?
• How could we have more collaboration between
  universities and healthcare organisations
  (including improvement centers)?
• Teaching teachers
• How can we evaluate and assess learning?

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Towards a breakthrough in Quality Improvement
education?
Elective in patient safety
Interprofessional elective Building the future
health care
Exerience based learning for QI facilitators
OI and safety for Residents
Masters students
Webcourse in Improvement
Group dynamics and leadership
15 PhD students 5 post docs
University collaborative
Distance course Learning and Improvement
knowledge
Local breakthrough projects
Teamwork and QI at teaching ward
Medical management Centre KI
15
Towards a breakthrough in Quality Improvement
education?
Elective in patient safety
Interprofessional elective Building the future
health care
Exerience based learning for QI facilitators
OI and safety for Residents
Masters students
Webcourse in Improvement
Group dynamics and leadership
15 PhD students 5 post docs
University collaborative
Distance course Learning and Improvement
knowledge
Local breakthrough projects
Teamwork and QI at teaching ward
Medical management Centre KI
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New requirement for MD exams2007.01.01

• -the student should be able to demonstrate
  competence in initiating, participating, doing
  quality improvement and evaluate medical
  treatment.
• teamwork

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Requirements for residents in Sweden National
Board of Health and Welfare (2005-)

• Medical Competence
• Communication skills
• Leadership
• Science and Quality Improvement(how to gain new
  knowledge and put it into practice)

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Euripec 1996-European Interdisciplinary
Education Collaborative

• UK
• Norway
• Sweden
• Netherlands
• Finland
• representatives from USA

• Meeting in conjunction with European Forum on
  Quality Improvement in Health Care
• London - 96
• Paris -97
• Vienna -98
• Stockholm -99
• Amsterdam -00
• Bologna -01
• Edinburgh -02

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Followed by other initatiatives

• The Rosendal Meeting, DNF Norway 2003
• ESQH Summercamps
• Hastings, England 2004
• Porto, Portugal 2005
• Roundtable in Prague 2006
• Roundtable in Barcelona 2007

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Be prepared to meet and overcome resistance
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• Many Thanks for your attention!
• Karin.Pukk_at_ki.se