IHI Open School Spreads to Ireland

February 2013

The IHI Open School courses – online modules that teach the basics of quality improvement and patient safety – have become integrated into training and curricula around the world. They have been assimilated into dozens of health professions schools and several forward-thinking health care organizations. There’s even an ongoing project to embed the courses into every health professional school in the state of South Dakota.

Up next? Ireland. 

Marie Kehoe-O’Sullivan, the Director of Safety and Quality Improvement at the Health Information and Quality Authority (HIQA), is leading a charge to use the IHI Open School courses as a training program for all of the Emerald Isle. She kicked off the program for frontline staff in January of this year by buying 100 course licenses, a number that will increase year after year, she says, until the country reaches a critical mass of patient safety champions.

Marie at IHI launch.jpg“Online education is such a common sense approach,” Kehoe-O’Sullivan says. “The modules are interactive and the vignettes are just so good. It’s such an efficient way to train people. It’s almost too good to be true.”

The aim of the Irish program is both clear and succinct. 

“The ultimate goal of the whole thing is to make patients safer,” she says. “It’s to have better, safer care in Ireland.”

Andy Carson-Stevens, the IHI Open School Regional Leader in the UK, was integral in setting up the program. (Jennifer Shaver, a clinical informatics analyst from Claxton-Hepburn Medical Center in upstate New York was, too, says Kehoe-O’Sullivan.) Carson-Stevens is thrilled at the potential for change in Ireland’s health care system.

“This is an exciting development where the IHI Open School is supporting the building of capacity and capability for an entire nation,” he says. “A program like this will really boost critical skills and knowledge, and in the end, greatly benefit the patients health care professionals serve.”

Kehoe-O’Sullivan was one of those professionals for more than two decades. A nurse by background, she delivered care at bedsides in the US and Ireland. Since she understands the complexity of the health care system, she knows her goals for this project are ambitious. She’s honest about the challenges of changing a whole country’s health care system, but has energy and optimism about the road ahead.

“I’ve been a quality and patient safety manager for 10 years and I know the staff out there – from porters and caterers to nurses and physicians – all want to do the right things,” she says. “Staff members are volunteering for this program.”

Staff members – in interprofessional groups of 10 – are raising their hands at 10 different sites across the country, including four acute hospital sites and six community settings. The locations were selected to make sure the country was fairly represented geographically and that different types of health settings – large and small, rural and urban – could participate. Working with 100 staff members, Kehoe-O’Sullivan says, is their attempt at starting small.

“It’s the QI thinking,” Kehoe-O’Sullivan says. “We wanted to start smaller, but we would have had a mutiny if we picked only one particular region.”

HIQA, a government-funded agency that monitors and regulates safety and quality in health care, is training 20 internal staff members as well. It is also supplying the licenses to the 10 sites, which is welcome help to the hospitals. “The health service is on its knees financially,” Kehoe-O’Sullivan says.

HIQA is also responsible for a new set of standards it launched in June of 2012 to promote safer health care in all settings. Kehoe-O’Sullivan, who has been in her role since July, is charged with providing the education that will give staff – and their organizations – the ability to meet the standards. To go along with the IHI Open School courses (staff members will be expected to complete two each month), Kehoe-O’Sullivan and other staff from HIQA will hold weekly conference calls and monthly face-to-face meetings to reinforce important lessons and answer any logistical or content questions.

“It’s to give the extra support,” Kehoe-O’Sullivan says. “We’re not just going to hand out a [course] license and expect that it will get done.”

Eight meetings once a month for 12 months will make for a busy schedule at HIQA, but Kehoe-O’Sullivan knows it will be worth it in the long run. And she expects her team will be learning every step of the way.

“I’m sure we’ll make loads of mistakes,” she says. “But it’s QI in action. We will learn from the things that don’t go well.”

They are also hoping to learn how to improve the medication safety – and more specifically, the medication reconciliation process – in the country. Inspections done by HIQA in the past revealed that reconciling medications was a problem area for the country and an obvious spot to target in 2013. The result, Kehoe-O’Sullivan hopes, will be a Quality Improvement Program in Medication Reconciliation that will be implemented nationally in 2014. The success of the project, along with pre- and post-surveys of staff, and an external evaluator, will help determine the efficacy of the initiative.

“We’ll be looking to see if we conducted the program the right way,” Kehoe-O’Sullivan says. “And if IHI [Open School courses] was the correct program to use.”

By the end of this year, all 100 staff members in the first wave of the program will earn their IHI Open School Basic Certificate, which is awarded after completing 16 of the 19 courses in the catalog. Despite the extra work, Kehoe-O’Sullivan doesn’t worry that staff will see it as yet another requirement.

“That’s the only thing I’m not worried about,” she says with a laugh. “People are excited about the opportunity to learn all this. It’s an amazing opportunity to train people in a cost-effective – and time-effective – way.” 

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