Better work force training to improve quality of care

Changes are needed in the education of physicians, nurses, and other health professionals to improve patient safety and quality of care, according to a new report by the Institute of Medicine (IOM) in Washington, DC. For example, the IOM says licensing boards should require physicians, nurses, and other health workers to demonstrate their clinical skills and understanding of medical advances, rather than let the professionals simply take a class and pay a fee to renew a license.

According to the report, "five core competencies" should be adopted for programs that train health professionals: the abilities to deliver patient-centered care, to work as a member of an interdisciplinary team, to engage in evidence-based practice, to apply quality improvement approaches, and to use information technology.

In addition, the report, Health Professions Education: A Bridge to Quality, said licensing and accreditation organizations should ensure that students and working professionals develop and maintain proficiency in these areas.

Patient-centered care involves identifying and respecting patients’ differences, values, and preferences, and includes relief of pain and suffering, the report said. For quality improvement, health professionals should identify hazards and errors, measure the quality of care, and test interventions to change processes and systems that improve quality. The fifth core element, in the area of "informatics," involves the use of information technology to mitigate errors and manage knowledge, according to the report.

One specific recommendation in the report is that the Centers for Medicare & Medicaid Services should take the lead in funding experiments that will enable and create incentives for health professionals to integrate the interdisciplinary approach into educational or practice settings. This would be done through Medicare demonstration projects, with the goal of providing a training ground for students and clinicians that incorporates the five core competencies.

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