Integrating a Patient Safety Conference into Graduate Medical Education.

OBJECTIVES: The Institute of Medicine has established aims for improvement in patient care that emphasize safe, timely, effective, efficient, equitable, and patient-centered medicine. This goal is echoed by the Accreditation Council for Graduate Medical Education (ACGME).

METHODS: The National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) graduate medical education program implemented a Clinical Learning Environment Review (CLER) project whose aim is to support a patient and trainee safety environment. An ongoing biannual patient and learner safety conference is able to capture close calls, safety attitudes, potential learner mistreatment, and trainee fatigue in a nonpunitive manner that supports answering the question, "What was learned and what needs to be improved?"

RESULTS: Group recommendations were captured at a quality improvement conference. We documented a shift in attitudes away from one where the institution is perceived to be weakest at supporting safety reporting.

CONCLUSIONS: This project is designed to serve as a mechanism for insuring care that is respectful and responsive to patient needs and values. It identifies keys to avoiding wasted re-sources or harmful delay while also seeking to improve care based upon scientific knowledge.