 Thank you very much Joe. Joe has been several points during the day today very effusive and great expressed his gratitude to me but I really Want to tell everybody the truth Which is that there are a number of other people who deserve a lot more credit than I do for the curriculum that we're about to announce and First among all of them is Joe Keane because at that first meeting less than two years ago I was not at that time very much involved in patient safety And it was Joe's passion and the compelling case that he made that really And we agreed on everything. It just it was just no way to do anything other than to take this on It's not as if I don't have a day job But but it's been it's been very exciting and it would not be happening without you Joe There are people in the audience who contributed significantly to this through their role on the working group which met in person three or four times in various places and And met by phone every other week for the last year and a half a year ago when we were in London and I expressed the progress we were making I really just basically described the concept that we were still Shaping and I will confess that standing at the podium at that time I was nervous that one year was not going to be enough for us to be able to produce something that we'd be proud of but I Can tell you that it's with great pleasure and pride that I'm Describing the curriculum that we are launching today And so I'm very grateful to people in the audience such as Steve Barker and Alicia Cole who has been an inspiration to the group Lee Fleischer Ron Jordan Phil Griner as well as Ariana and Michelle from the From the foundation But I think all of them would agree that we would not have a product that is in such good shape To announce today if it weren't for my co-chair on this group dr. Peggy Shoemaker who also is The chair of a working group that I formed at Geisinger Commonwealth School of Medicine to create a patient safety curriculum within our medical school and So Peggy is sitting somewhere over there And and she deserves Certainly more credit than I do for what we're what we're about to announce so the Charge that we gave to the to the committee was not to reproduce The curricula some of them really wonderful curricula and patient safety that are already out there from Organizations like the Institute Institute for Healthcare Improvement or the World Health Organization or professional societies that have got components of patient safety built into their curricula and certainly Nursing profession leads the way on this But what Joe was so concerned about was that these have not moved the needle in health professions education They have not been widely adopted and our goal was to create a curriculum. That's adaptable Adaptable to clinical learners across the spectrum of professional maturity from novice to expert and across all health professions And so for example the double AMC the Association of American Medical Colleges with whom I've been in touch about our curriculum is Creating a set of competencies to define requirements upon graduation from medical school one point in the in the professional continuum of One profession ours is much more ambitious It also at its core emphasizes the benefits of team-based interprofessional care and very importantly and Consistently with the core values of this foundation, which I think makes this foundation so successful in pursuit of its goals is The centrality of the patient voice and the family voice in the experience that the patient gets in health care Making the patient not somebody that the professionals value as they take care of the passive patient But making the patient an active participant in their own care and respecting that role Alicia's story and so many other stories that we've heard Tell us that when that does not happen the patient suffers and so that is a central component of the of this curriculum and so the virtues of the curriculum that we're so proud of is Is that the is in the structure and the adaptability of what we've created? So the content is largely not new in his content that is pulled from other places. We have created content but the modularity allows instructors and professors and and teachers to look at their own curricula identify what they're already teaching identify what's missing use our framework of Domains and competencies as a guide to what's important to teach and then choose from the material that we identify the material that is appropriate for that level of learner appropriate to that profession And so the people can choose to use our our material in a modular way It's suitable for a variety of teaching strategies whether it's in the old-fashioned way of talking at people with which I'm doing to you right now or the more Any of the more recently adopted and very popular and successful methods of active learning Suitable for the clinical setting for teaching in the clinical setting as well It's conducive to delivery by people who may not be experts in patient safety But as long as they care about it and they understand the material they can use our material to to To lead education for those learners It's practical in terms of time requirements because it's modular and adaptable and so the facilitators and teachers can adapt it to the setting It's got many experiential components and And we use as I will describe in a few minutes a wide range of resources to support the educational content and I want to emphasize that as with In my view everything else In medical education and health professional education. Yes, it's important to teach Knowledge and yes, it's important to teach skills But that is far from the whole the entire goal of Education My view of education in a medical school and I think it's true for all health professions is that we are forming the professional identity of these future caregivers and Their professional identity has to include as a fundamental component Ownership for their role in the successful outcome on behalf of their patients ownership for their Responsibility of the patient experience and that is something that is a value that is in this curriculum And so I'm going to describe very briefly What is described more fully in the 70 page document that is now live online and that will soon be available to you In hard copy as well the structure of what we have created so The overlying structure is the identification of eight Fundamental domains of patient safety. I'll go through them these domains Overlap quite a bit with the domains in the curricula from the IHI and the WHO that are already out there many of them are the same and These should not be viewed as discreet siloed domains in which the content is separate in each of these domains the content very much overlaps and so in one sense you could say that the definition of these domains is arbitrary and We would probably acknowledge that but I think it's very important to acknowledge that every single one of them is critical to patient safety and so we've identified Four of these domains is foundational to everything else and those are error science system science human factors and technology Two of these domains are linking domains that link everything else and those are teamwork and communication And it's hard to over emphasize the importance of that one And I'm very grateful to anagret Hanawa who has helped the work the who spoke last year on the panel in London And it was helpful very helpful to the team and the computer communication curriculum and Leadership and leading change those are the two linking Domains and then two domains. We are labeling as Aspirational domains Aspirational doesn't mean we don't think we'll ever get there aspirational means that these are are the are Trans transformatively important in this curriculum and that is a culture of safety and Patient-oriented safe care so I am I'd like to if you want to read the definition of these domains with the group which the group worked on for each one of them They're in the in the 70 page document. I would encourage you to read them But I will I will start by just reading two of them the culture of safety the two that I said are aspirational Culture of so safety is a domain that identifies an ideal culture as one that would promote patient safety addressing elements of organizational culture professionalism ethics disclosure and an effective learning system and they need to emphasize that a curriculum alone is Not going to get us there because we know that in education in any setting what is so important is what the learner sees modeled by their role models and sees Practiced in the setting in which they learn and so if we don't actually have a culture of safety In our clinical setting Then teaching a culture of safety is only one component of getting there And so the goals the overarching goals of the patient safety movement foundation are all mutually interdependent Patient-oriented safe care is a domain that is devoted to patients and families navigating health care With attention to the relationship-centered communication Engagement of the patient and family as valued team members an appreciation of safe care From the from the recipients perspective, so we think these are all fundamentally important This is the framework these eight domains are the overlying framework for the curriculum as a whole and Then within each domain There there is a structure and so what I'm going to describe first is a modular design and then I'll take you through just one example So for each domain We have at the beginning of that part of the curriculum a definition of that domain I just read you two of them and a sticky note it It isn't actually physically a sticky note, but it really looks like one and that sticky note links that domain With national patient safety goals and I'll give you an example of that and then with each eat eat within each domain There are sub domains that are more specific and within each sub domain. There are learning objectives and then For each learning objective there are examples multiple examples of how you demonstrate competency for that objective and So I'll give you an example of that and we'll talk about how people can then use this curriculum so we'll take as Well as an example of one domain the very important domain of teamwork and communication This domain and this is that it starts with the definition of the domain and here is the sticky note linking it to joint Commission national patient safety goals of Communicate medication information teamwork training etc so this domain of teamwork and communication Addresses the concept of teams and health care delivery and emphasizes the knowledge attributes skills and behaviors required of Effective teams to deliver safe care error prone gaps in care are highlighted with content offering validated communication frameworks to ensure patients safe transitions across the health care experience and So if we look at the sub domains within teamwork and communication those domains are teams in health care handoffs and gaps team steps and Within each of those sub domains. I'll give you an example of just one learning objective so the learning objective for teams in health care a learning objective is to For example recognize if you're a novice. There's a developmental verb is different depending on the stage of development so to recognize the benefits of effective interprofessional teams and their role in patient safety and depending on your Level of maturity along the spectrum you might recognize you might articulate you might value you might model and for an expert you would teach that and Then each of those is linked with resources and there's a wide range of resources and they're taken from multiple Sources they include role-play materials to help facilitators establish a Scenario in a small group setting where people play different roles and and enact scenarios That that emphasize points regarding safety There are videos and of course stories Stories have been important in every presentation that I've ever attended of the patient safety movement foundation and They are so critical and effective teaching and so we've built stories throughout this curriculum in videos in examples of cases Local experiences can be brought in For group discussion. We we have multiple links to online resources and materials for didactic Some of which are taken from things you may remember Those of you who are as old as I am called textbooks We use that too we are very ecumenical in this and supplemental readings all sorts of resources and so here's an example of I've essentially already described this a novice would be expected to demonstrate Competency in the learning of this sub domain learning objective Recognize the benefits of ineffective interprofessional teams and their role in patient safety an advanced beginner would be able to articulate those benefits a competent learner Would value the benefits of effective interprofessional teams and their roles of patient safety that might for example be a resident in the hospital setting Somebody who's proficient would model those benefits That would be somebody who's finished residency training and is now practicing and an expert is somebody who's mature in their practice skills Who would be expected to teach the role of effective interprofessional teams and so the cover Page of our curriculum calls it a patient safety curriculum in schools. I think this is the only example I can think of Joe where you've been not sufficiently ambitious in your goals So I think we should change the title the patient safety curriculum for all health professionals no matter how mature they are so How would how would a novice who needs to recognize the benefits of effective interprofessional teams Demonstrate that competency so we give a number of ways that the teacher can choose to have the learner demonstrate that they could After a discussion of case studies they can expect that the student will be able to identify the benefits of interprofessional teams or after a didactic session a student should be able to list the essential characteristics of highly highly functioning interprofessional teams of or following a didactic session the student can list the benefits of Of interprofessional teams that includes the patient family voice Etc. So you you get the idea multiple ways that that the teacher can Can choose to have a student demonstrate competency Multiple sources of resources for the facilitators so We have videos and patient stories that are some of which are on YouTube some of which are on various websites And what they all have in common is that they are all compelling Real-life experiences that are built into case examples and role-play Sessions Online resources a wide range of online resources that include links to websites a wide range of materials for didactics and supplemental readings materials for role-play which includes scripts and or or a description of each role and the responsibilities in the exercise and you've got 20 minutes to imagine you're the patient and you're the nurse and And and et cetera and to enact scenarios And of course supplemental readings and for those of you who don't recognize it those lower right-hand corner or it's a stack of books so This is not the the idea is to make this as easy as possible as user-friendly as possible to implement So how will you all implement this? That's I'm not using the subjunctive mode. I'm using I'm simply describing what you will all do first go back to your setting whether that is a school or a clinic or a hospital or a Tech company Or an insurance company And look at the content of what you've what you're already doing. You're all doing Education one way or another look at that content and see what's in there. That's already patient safety It may not be consciously labeled as patient safety, but see whether it is Line that up with our competencies domains and subdomains and see where the gaps are and Then you've got to get commitment from the people who are responsible for professional development in your organization To do this But choose material that's appropriate from this wide range of material in the curriculum that will fill those gaps And and the third point is the faculty development is very important because you need to Orient the faculty to the goals of the curriculum and how to use the curriculum so you can start small And integrate it into your existing and developing our curriculum and so I'm going to linger on this slide with this behind me To describe to you what we are doing at the Geisinger Commonwealth School of Medicine to do just this So first of all Joe you didn't I haven't had a chance to tell you this but in the last few months The Geisinger has been in the process of a strategic of strategic planning for the entire Geisinger system Which to put it in context is about half the size of partners we heard about earlier and The values of that system have been learning innovation Kindness and excellence and those have been the mantra for the last several years two months ago Geisinger agreed to add a fifth value a fifth fundamental value to everything that happens at Geisinger, which is quality and safety and Neil Martin the chief quality officer who's been to these meetings is in the center of that and so at Geisinger's medical school the Geisinger Commonwealth School of Medicine as I've mentioned Peggy Shoemaker once again who co-chaired this task force Chairs our medical schools task force and so what she has already done is to meet with course directors people who run the various components of the curriculum throughout the four years To identify the gaps in the curriculum to map it against our Our curriculum to identify those gaps and to choose material to fill those gaps just as I've As I've said in the in the first bullet here And that is already beginning to happen this spring The course directors are on board with this. They're excited about this And they're working with Peggy to identify the content and identify the right places throughout the four years of the curriculum to fit it in But we are not limiting ourselves to the undergraduate medical experience. I Am the dean of the medical school. I'm also the chief academic officer of the Geisinger system So all of Geisinger's residency programs come under me all of Geisinger's educational programs in all the health professions come under me as chief academic officer and The people who lead those efforts Several of them have been on this task force So our associate dean for graduate medical education is on this task force enlisted in the book Our associate dean for continuing professional development has been on the task force and so they are working with the residency program directors to Offer the curriculum now that we as of today can actually give them the curriculum And they've got buy-in from the residency program directors to look at their residency curricula we have 56 residency and fellowship programs and My hope is that all of them will incorporate this content into the didactic curriculum for the residencies and fellowships To work this into the curricula for nursing students and for a pharmacy students a wonderful pharmacy program and And the continuing professional development of the 1600 providers in the Geisinger system And so Joe you didn't ask us to do that you asked us to think about schools, but we were thinking much more broadly than that so So that is what we are doing and that is the challenge to you We expect you To look at this curriculum To go back and and examine what you're already doing in patient safety because I bet you're all doing something and to incorporate this to the extent you possibly can on behalf of our patients and keeping in mind That the goal of this curriculum is not merely to import knowledge and to get people to know what they need to do But for them to take ownership as part of their identity They're moral obligation to their patients that they need to do this and it is our obligation that we need to inspire them to do this and So with that, I'll yield the rest of my time to Joe sure I'd like you to share with the audience of Your recent interactions with both the medical school staff and the hospital staff and as you've told them about this curriculum And how they reacted to it. Well our we've we have not brought it out widely to the staff as a whole Because we can't give them a curriculum. We will do that now but what I have done is I've presented this to the guys in your leadership and They were I thought they'd be politely interested and I was certainly expected the chief nursing officer and chief medical officer to be very interested and of course they were But every single executive vice president across the guys in your system and there are 12 of them Express great enthusiasm and several of them contacted me throughout that day to tell me about how for example the chief scientific officer said I want to read that 70 page curriculum because I think they're going to be opportunities for our scientists To do research on patient safety and our we have a chief innovation officer Who is the former secretary of health for the state of Pennsylvania? Who has said that she wants to use the curriculum to build nudges? Into geysers for example for example electronic ordering system for providers and the CEO was very enthusiastic and Was starting to strategize with me about how we get this person or that person to so there's there's a huge enthusiasm Wow, thank you, and that's that's what you should expect when you try to take this out to your institution and Thank you for your leadership. See I know you had a wonderful group of people working hard behind the scenes with you This is not easy. You really have created the gold mine that hopefully will hardwire Patient safety for generations to come and this is not a finished product. It's a this is oh This is a living document the group will continue meeting probably not every other week, but but Because there will be new new content Continually appearing and we'll need to link it with domains as technology advances as we can do more for patients there will be more competencies will want to define and a very substantial challenge will be Implementation so I think we want to strategize about disseminating the news about this and Convincing professional societies to utilize this I think several of them were already interested and as the points been made by several people convincing licensing boards Including the LC me but but all the others To incorporate this content into their board exams. That's what will really get it adapted The work has just begun great, but thank you. Thank you so much. See great work. Thank you. Thank you