Safety Web site is aiming to change doctors' attitudes

After physicians complete the National Patient Safety Foundation's new interactive, Web-based educational module, they will think differently about patient safety "in a very substantial way," said the man who spearheaded the project.

The program drives home the messages that errors are "imbedded" in health care systems; that systems of checks, balances and openness are needed to prevent patient harm; and that a culture of blame serves to drive errors underground, said William R. Hendee, PhD, senior associate dean and vice president of the Medical College of Wisconsin in Milwaukee.

"We're all human, and we all make mistakes, so what we need to do is design systems that recognize this and reduce the risk of errors," said Dr. Hendee, a founding board member of the NPSF, of which the AMA was a founding sponsor. "Health care is delivered by people, and people are prone to making errors."

Dr. Hendee said it is important that there be a spirit of openness where people are encouraged to report errors.

Three years in the making and funded by a $782,588 grant from the U.S. Agency for Healthcare Research and Quality, the Web site contains modules for physicians, nurses and patients. It covers topics such as medication safety, disclosure of errors, learning from errors, pediatric care, medical device safety and anesthesia.

Physicians are eligible for continuing medical education credit. MCW Director of CME Michael O'Donnell, MPH, said more than 40 certificates were awarded to physicians in the first weeks of the program.

Dr. Hendee said the Web site is appropriate for doctors in both outpatient and inpatient settings.

"When a wrong diagnosis of a patient is made, it's an error; when a patient in a nursing home who is not escorted to his meal falls, it's an error; and when a patient is not using his medicine at home because of a lack of supervision, it's an error.

"All of these arenas in health care are subject to errors in judgment and errors in process," he said.