Don Tyson, RN, PhD, is Associate Professor of Nursing and Director
of the Master of Science in Nursing Program at Eastern Mennonite University in
Harrisonburg, VA, USA. Tyson uses the IHI Open School courses in his final semester
nursing course on leadership and in his graduate-level patient safety and
quality improvement (QI) courses. We asked him a few questions to understand
how he uses the courses and the results he’s seen. “I grew up in a culture of
blame, but I teach a safety culture,” Tyson says. “We need to strike a
balance.” Learn more about using the IHI Open School courses in your curriculum here.
OS: How did you first
learn about QI and patient safety? Why does it matter to you?
DT: It goes back to the 1980s. When I was a critical care
director, I was doing the old-fashioned quality assurance. Then I went to an
IHI Conference in Boston related to critical care, and heard Dr. Don Berwick
and others speak. That was life-changing perspective for me. As a nurse in
critical care, post-anesthesia care units (PACU), and operating rooms, I have
seen too many safety issues. The only real way to change and create a culture
of safety is through a QI approach.
OS: Why incorporate
QI and patient safety into a course on leadership in nursing school?
DT: All nurses are expected to understand QI. The Commission
on Collegiate Nursing Education standards mandate it, but more importantly,
nurses need to understand their own personal responsibility for safe practice, and
be reassured that we need to look at things from a safety perspective. As
graduates, they will be asked to participate in quality initiatives wherever
they practice. This is the time to learn it. Being a leader — influencing
change from bedside to the board room — this is their opportunity to learn how
to create that change.
What do you feel the
Open School courses contribute to your students’ knowledge?
They love the modules. And they get to hear from someone
besides myself and boring textbooks. The courses are real life. And they get to
see it’s more than an academic exercise. One of my former students called me
some months back to say she was asked to serve on a QI committee, and she
realized at that first meeting that the IHI courses provided her a solid
background for her service on the committee.
OS: How have your
students responded to learning about QI and patient safety?
DT: They have been very positive about it. Course
evaluations indicated how the modules were very effective in their learning. As
I mentioned, they have come back to me about how they used the actual knowledge
in later work settings.
How do students apply
their learning in your course?
We use the Model for Improvement in class to discuss a case
regarding a nursing department needing to identify a focus for a QI study.
Second, they analyze an article from a professional journal about a QI project.
They describe how the article represents each step of the model from problem
identification through at least one plan-do-study-act (PDSA) cycle.
What advice would you
offer other professors of nursing (or other health professions, for that
matter) about teaching QI and patient safety?
Use the modules. They are great.
I also would like to see more about the balance between
personal responsibility and system responsibility. I grew up in a culture of
blame, but I teach a safety culture. However, I believe as professionals we all
need to take personal accountability for our actions when mistakes are made.
But unfortunately, I hear both staff and students still have an attitude of
needing to blame. Patrice Spath mentions in her book, Error Reduction in Health Care, that
blame is a human tendency. That was eye-opening for me. We need more
conversation on how to strike a balance. I am a middle-of-the-road kind of