These IHI modules are optional – IHI online open school. Supplementary activity to provide greater detail and context for the material covered in class. Recommended for students pursing a certificate in quality and safety.
This module provides additional detail regarding organization culture, safety culture, high reliability organizations, and reporting systems.
PS 102 Lessons 1- 3
This module provides additional discussion of the Swiss Cheese Model, active and latent failures, unsafe acts, and harm.
PS 103 Lesson 1
This module describes human factors contributing to error and distinguishes between internal and external human factors.
These modules are intended for students working to complete the certificate program.
GOAL: Develop awareness of psychological safety and its importance in teamwork.
In high-functioning teams, every member feels able to disclose errors, near-misses, or unsafe situations without fear of punishment or retaliation. Creating this culture of safety requires openness, trust, and leadership. As you watch this video, consider situations that you have witnessed in your clinical experiences. How would you characterize the psychological safety in these environments?
Goal: Apply the concepts of toxic stress and adverse childhood events to the cycle of interpersonal violence, and identify opportunities for clinician intervention.
Context and Instructions: In this JAMA article, Sumner et al explore the epidemiology of interpersonal violence, the effect of childhood exposure to violence on lifetime risk of violence and adverse health, and opportunities for community and clinician intervention.
Goal: Describe the proposed pathophysiologic mechanisms of toxic stress’ effect on health across the lifespan and the mediating effect of known resilience factors.
Context and Instructions: In this Pediatrics article, Shonkoff et al, delve into the science of toxic stress on the developing brain and the moderating effect of resilience factors. Based on this science, they propose an “ecobiodevelopmental framework” from which the clinicians of the future should approach primary care.
Goal: For students who want to read the Kaiser study that introduced the idea of ACES and the impact on health. A caveat that some language in this original paper (“family dysfunction”) would not be used in the trauma informed care environment that this work ultimately produced.
2) Watch video of Carol Gilligan on Moral Development and Care Ethics.
GOAL: Understand the basics of care ethics and how it might apply to the clinical setting.
Consider what is different about the approach that Gilligan is suggesting (i.e. a relational or Care Ethics based approach) from what you typically think of in terms of your ethical obligations as physicians.
GOAL: Consider what you learned from Gilligan’s video and the above ethics key terms in this complex case of refusal of life sustaining treatment (LST).
Consider this is just one instance among a myriad of different clinical-community interactions. It will help us to begin to see the importance and sometimes the difficulty of respecting and valuing different community-based and relationship-based values and beliefs.
Have you ever found your own personal and community-based beliefs to be in tension with the norms of the institution of medicine?
McLeroy, Bibeau, Steckler and Glanz are generally credited with creating the social ecological model of care. A quick Google search for the social ecological model will reinforce how widely it has been adopted. There are numerous community, state, national and international organizations that utilize this model in their programs.
Think back to your session in immersion on the social history. How often do you think beyond the individual and interpersonal factors that influence you and your patients health?