A Quality Movement in Qatar: Front-line Staff Complete IHI Open School Courses in Droves

July 2013

Minara Chowdhury, an assistant executive director at the Center for Healthcare Improvement within the Hamad Medical Corporation (HMC), reads the numbers slowly over the phone:

“Let’s see, we have 4,200 registrations, 2,458 participants who have completed at least one course, and a total 18,000 courses completed overall to date,” she says, before pausing for a few moments. “Wow, 18,000. That’s amazing.”

As part of its commitment to quality of care and patient safety, HMC acquired subscriptions to the Institute for Healthcare Improvement (IHI) Open School to support continuous learning for its staff. Since the arrangement was made in May 2013, HMC has witnessed an unprecedented interest from staff who have registered. The IHI Open School was officially introduced to attendees at the Middle East Forum on Quality Improvement in Healthcare in Doha, Qatar, in mid-May. In only two months, since then, thousands of front-line staff — including physicians, nurses, pharmacists, and other staff — have completed IHI Open School courses at a startling rate. In addition to the numbers above, 759 staff have completed the five priority courses (as determined by HMC) and 438 staff have completed all 16 courses and earned their Basic Certificate.

HamadLobby2.jpgThe statistics are also impressive to Nasser Al Naimi, Executive Director of the Center for Healthcare Improvement at HMC, who is helping to manage the enormous program.

“I’m very surprised,” Al Naimi says. “Even now, as we’re in Ramadan, the Islamic month of fasting, with staff fasting during the day and working reduced hours, the rate of completing courses is amazing. I’m really amazed and delighted at the dedication with which our staff have pursued this wonderful learning opportunity.”

He has also expressed his excitement at the possible outcomes that this online learning facility offers to professional health care workers around the world.

“What we’re trying to do is build capacity and capability in the organization,” Al Naimi says. “Our organization is very large (more than 20,000 employees), and culturally diverse with at least 80 different nationalities working together. Everyone comes together with their individual ideas of safety and improvement that are practiced in their own country, and we need a baseline to ensure we promote common quality and safety standards across our hospitals that are in the best interest of our patients. The Open School is helping us create this baseline of knowledge and understanding.”

Developing a common language of improvement is critical for an organization that serves 75 percent of the two million people who live in Qatar. Patient safety and quality improvement have always been in the spotlight at the organization, Al Naimi says, but working with IHI and the Open School will take HMC and its employees to the next level. 

HamadTheatre3.jpg“The vision is to make these courses accessible to all of our staff,” he says. “We want to roll them out to support services and administrative staff as a next step. But first, we want to train as many clinical front-line staff as possible.”

Nurses, the largest clinical group at the organization, are leading the charge through the courses. They account for more than 2,700 registrations and more than 12,000 courses completed. More than 400 physicians have completed more than 1,200 courses, and pharmacists have completed more than 250 courses. The priority courses include QI 101: Fundamentals of Improvement, QI 102: The Model for Improvement: Your Engine for Change, QI 103: Measuring for Improvement, PS 100: Introduction to Patient Safety, and L 101: Becoming a Leader in Health Care.

“I would have expected the nurses to lead this,” Chowdhury explains. “They really feel the excitement of putting learning from a course into practice.”

Staff throughout the eight-hospital system will have the opportunity to apply their learning in a campaign at HMC in the coming months. The campaign is still being framed. In essence, it will revolve around reducing harm and using plan-do-study-act (PDSA) cycles to make improvements on the front line.

But for now, there’s still more work to be done to build capability. HMC’s campaign leadership team identified four factors that have helped HMC succeed in rolling the program out to such a large group of staff:

  1. Capitalize on the energy created by a big event. In this case, it was the Middle East Forum.
  2. Make the training free for staff (if possible), which is a big selling point.
  3. Consider a competition. The project organizers put everyone who completed the five priority courses into a drawing for eight iPads.
  4. Encourage staff and follow-up often. HMC has set up education stations and a call center to help staff get registered.

HMC’s campaign leadership team expects the registrations and course completions to keep rising for some time. The challenge, it says, will be making the course content relevant and accessible for all staff.

“We will face a number of challenges around Arabic language and interpretation,” Al Naimi says about the courses, which are available only in English, Spanish, and Portuguese. “We’re going to have to think about how we can make the courses truly accessible to all.”
HMC is one of more than 450 organizations that are using the online modules to train staff.

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