The Area of Concentration (AOC) is a voluntary program that allows medical students to pursue a rigorous, four-year academic program in an area of specific interest while studying the standard medical school curriculum.

 

The Area of Concentration in Patient Safety is designed for students with an interest in developing additional expertise in the context in which care is delivered and how that context affects the safety of our patients.  This area of concentration could be called healthcare systems, quality of care delivery, or comparative healthcare.  We have chosen patient safety not to narrow the appeal of this AOC but to help students interested in any of the above areas survive the complexity of the issues involved by giving them a beacon to always return to: the well being of patients.  A certificate from the School of Medicine will be awarded at the completion of four years of requirements.

 

The Patient Safety AOC prepares interested medical students for healthcare careers in an increasingly mosaic set of cultural, regulatory and financial constraints that can at times obscure the purpose of becoming physicians.  This AOC encompasses the body of knowledge regarding healthcare delivery and its affect on patient well being: hospital regulations, federal and state regulations, reimbursement schedules, Medicare and Medicaid, organizational behavior, professional attitudes and habits, error analysis, quality improvement processes, risk analysis, effecting change.  The AOC promotes the development of skills that will enable a practicing physician to seek out the root causes of problems they encounter and think creatively about applicable and realistic solutions.  Students who participate in the AOC in Patient Safety recognize that problems affecting their practice and their patients are often widespread and require commitment and engagement to further the patient’s best interests.

 

With increased cost and time pressures, healthcare is constantly reevaluating itself and innovating its delivery paradigms.  Without the proper involvement of physicians in this process the interests of patients and the requirements of proper care can be short shrifted and patient’s safety compromised.  The aspiration of this AOC is to give graduating physicians a chance to reflect on and digest the problems they will be encountering later in delivering high quality care.  The hope is that this may motivate them to aggressively assist in correcting these problems during their medical careers.

 

Goals:

 

This program is designed to meet three major goals:

 

·                   To increase student understanding about the nature of healthcare delivery and its impact on patient care.

·                  To prepare medical students for careers in which they must be part of a team and work within a system.

·                   To encourage medical students and physicians to participate in the creation, implementation and evaluation of policies and programs that address the quality and safety problems faced by healthcare and others.

 

Program Objectives:

 

Faculty Mentor: Students maintain regular contact with a knowledgeable faculty member who has interest or experience in the area of patient safety. The faculty member oversees the student's academic program and progress.

 

Mentored Project: Students participate in research or a scholarly project under faculty supervision and disseminate their results in abstracts, poster presentations, publications, or related venues. This project may be used to satisfy the curriculum requirements for a scholarly project and may include such work as completion of an internship at the Consumer Health Project at PRHI as well as more formal research in the patient safety sciences. 

 

Community-based: Students visit at least two agencies, services, or programs associated with Patient Safety. This requirement can be met by visiting or volunteering at UPMC Presbyterian Patient Safety Committee, the WISER center, the Jewish Healthcare Foundation, the Pittsburgh Regional Healthcare Initiative, and others.

 

Patient Safety Elective Lectures: Students seek out at least 10 lectures throughout the year that take place at the School of Medicine, School of Public Health, Heinz School, Carnegie Mellon, or lectures sponsored by Jewish Health Care Foundation, Carnegie Foundation and others that touch upon issues of Patient Safety.  Patient Safety is a problem that affects more than just the medical community.  It is a peculiar issue that everyday affects the stability and purposes of the healthcare systems.

 

Patient Safety School Lecture Series: In each academic year, students invite at least two guests to the medical school to speak to an audience of their peers on issues of importance to their interest in this AOC.  These guest lectures not only help ensure that students remain active seeking out contacts in this field, but also create a forum to share their knowledge with their peers, and learn the challenges of organization and leadership.  Students will be required to attend the lectures organized by other students in the AOC. 

 

Fourth Year Elective: Students take a one-month elective in Patient Safety which can include such projects as attending Dr. Simmons condition C reviews during a critical care rotation; going abroad to Canada, France, Cuba, etc. and witnessing alternative healthcare delivery systems; participating in congressional or state legislative activities regarding the healthcare system; working with local healthcare organizations; or, implementing a patient safety initiative within UMPC.  The fourth year elective does not need to be a rotation, but must be a practical hands-on experience of the every day challenges involved in this field.

 

Reflective Journal: Students keep a reflective journal throughout the program. Entries may include thoughts or feelings during classes, patients encountered on standard rotations, ideas from AOC activities, and current events.

 

Portfolio: Students assemble a portfolio that includes a personal statement of philosophy, as well as papers, research projects, clinical notes, selected journal entries, evaluations, and other evidence of the educational experience. A committee of two faculty members evaluates the portfolio in the fourth year.

 

These requirements for the AOC span across all four years of medical school and include the following areas: Content, Service, Mentorship, Clinical Experience, and Scholarship. Opportunities to meet these requirements are delineated by year:

 

Achievement Timeline:

 

Year 1:

 

·                   Attendance at Patient Safety School Lecture Series.

·                    Attendance at Elective Lectures.

·                   Initiate meetings with potential faculty mentors for guidance during second year.

·                   By end of year: declare enrollment in the AOC.

 

Summer between Year 1 and Year 2:

 

·                   Required research or scholarly project in this field.

 

 

Year 2:

 

·                   With faculty guidance, develop a coherent plan for fulfilling the AOC requirements over the next three years.

·                   Continued attendance at student and elective lectures.

·                   Visits to community centers dealing with patient safety.

·                   Participation in poster presentations about scholarly projects.

·                   Reflective journaling and beginning of creation of portfolio.

·                    Selected readings on patient safety as they relate to standard curriculum.

·                   Periodic visits to community agency meetings or individual sessions (see above).

 

 

Year 3:

 

·                   Attendance at student and elective lectures if possible.

·                   Regular meetings with faculty member.

·                   Continued journaling and creation of portfolios.

 

 

Year 4:

 

·                   Attendance at student and elective lectures, if possible.

·                   Continued journaling and creation of portfolios.

·                   Fourth year elective in Patient Safety.

·                   Completion of research or scholarly project.

·                   Regular meetings with faculty member (at least 6 times during the year).

·                   Reflective journal for faculty evaluation.

·                   Presentation of portfolio.

 

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Patient Safety AOC University of Pittsburgh School of Medicine