Master of Science in Healthcare Quality and Safety

Operational Quality and Safety

Analyze the evolving definitions of quality and safety in health care, and how they can be measured and improved. Explore how culture, human factors and system theory affect safety science, and examine how detection methods affect error impact. Special focus areas include:

• Procedural safety
• Medication safety
• Ambulatory safety
• Cognitive bias

Informatics

Examine the role of informatics in health care improvement. Explore the digital infrastructure for capturing and organizing data, as well as user interfaces used by patients and providers. You will focus on how to collect and display data in the context of real improvement work. Other topics include health care privacy issues and the design of:

• Clinical databases
• Electronic health records
• Patient portals

Leadership

Gain an overview of leadership concepts that are most relevant to safety and quality, as well as those required to drive meaningful change. You will learn to initiate action in the current complex health care environment in which stakeholders have varying and often competing needs. Foundational concepts include:

• Change management
• Negotiation and consensus building
• Making a financial case for quality and safety
• Managing teams for improvement

Quantitative Approaches

Learn to assess outcomes specific to ongoing quality improvement (QI) research using statistical processes. You will examine study design—including measurement, bias, and sample sizes—and gain the skills to:

• Apply quantitative methods to QI work
• Analyze simple data and present findings
• Discuss and weigh general institutional review board (IRB) issues

Risk

Obtain an overview of malpractice and evolution of the field, along with strategies for promoting safety and error disclosure. You will explore innovations and interventions in different areas of risk, including:

• Diagnostic process
• Communication failures
• Procedural safety
• Medication safety

Capstone

Working one-on-one with a faculty mentor, you will apply the tools, strategies, and methods gained from the case studies and coursework to develop a solution to an evidence-based problem in health care delivery. The selected challenge may be driven by a need in:
•    Quality
•    Safety
•    Informatics
•    Risk

Examples of past capstone projects include:
•    Improving Initial Hospitalist-Patient Communication Experience Through Standardized Information Cards
•    Widespread Implementation of a Structured Handoff Across Boston Children’s Hospital
•    Improving the Patient Experience at Mount Auburn Hospital by Focusing on Communication about Medications

Learning Model

Offered in full-time (one year) and part-time (two years) options, this quality and safety program features a unique three-tiered academic model:

•Theoretical concepts that establish the foundational knowledge and skills required for quality and safety
•The opportunity to work one-on-one with a faculty mentor to apply best practices in a health care setting
•The capstone experience, in which students design an intervention intended to make an improvement to a problem they have identified and analyzed

The capstone culminates in a data-driven report that demonstrates an understanding of the concepts, how they apply to real-life situations, and the ways in which their intervention addressed those issues. Working with a faculty mentor, you will apply the tools, strategies, and methods gained from the case studies and coursework to develop a solution to an evidence-based problem in health care delivery. Upon graduation, our students will be qualified to serve as leaders at institutions of any size.

Safety Intensive

This course provides students with a foundation in patient safety. Beginning with the question, “Are we any safer than 20 years ago?” students explore the state of health care today. Fundamental concepts in safety follow, including the interplay of culture, human factors, and system theory as critical components of safety science. Approaches to adverse events are reviewed along with how detection methods can alter the impact of the error.

Special areas of focus are discussed, including procedural safety, medication safety, ambulatory safety, and cognitive bias.

Quality and Systems

After framing the current state of safety and quality in a historical perspective, this course builds on prerequisite learning modules to employ critical quality improvement (QI) tools and understand the power of data. Students focus on how to collect and display data in the context of real improvement work. The course shares examples of how data can change care at every level of the health care system. Students complete a short primer on systems engineering and two workshops on design and behavioral change.

Quantitative Approach to QI

This course teaches students to assess outcomes for ongoing QI research using statistics. You will examine study design—including measurement, bias, and sample sizes—and gain the skills to apply quantitative methods to QI work, analyze simple data and present findings, and discuss and weigh general institutional review board (IRB) issues

Longitudinal Seminars (I & II)

The fall seminar will focus on reviewing the framework for project work. Students will define a problem within an organization using QI tools, such as mapping, fishbone diagrams, and key driver diagrams, as well as input from local stakeholders. Interventions will be proposed by the end of the seminar, along with a projected implementation plan. Students will be asked to reflect on the process of moving from problem to design. This seminar will conclude with a poster session where students will share their work-in-progress and receive feedback from peers.

The spring seminar will begin with the implementation plan that students developed in Seminar I. Coached by their mentors, students will reflect on the process of implementation as they explore effective approaches to navigating change in a health care unit. This seminar will conclude with a capstone symposium during which candidates will briefly present both their projects and their reflections as learners.

Health Care Finance and Value

This course applies the lenses of value and cost to the health care delivery system. Students will learn about the evolving definitions of value from the perspective of different stakeholders in the health care system and their drivers for change. The varying definitions of costs and implications on value will be discussed.

Risk Innovation

This course presents an overview of malpractice and evolutions in the field, along with strategies for promoting safety and error disclosure. Students explore innovations and interventions in different areas of risk, including diagnostic process, communication failures, procedural safety, and medication safety.

Bioinformatics and Clinical Quality

This course serves as a primer on the role of informatics in health care improvement. Students will gain an understanding of the digital infrastructure that captures and organizes data, and the user interfaces for patients and providers. Topics will include the design of clinical databases, electronic health records, patient portals, as well as health care privacy issues.

Patient Engagement in QIPS

This course highlights the patient interface with the health care system and provides a unique perspective to health care professionals engaged in safety and quality improvement. Engaging patients in the improvement process is critical for success—from the reporting of events to intervention design to the training of health care providers.

This course takes a deep dive into multiple nodes, including the role of patient-family advisory councils, the voice of patients in event reporting, models to partner with patients in improvement work, and effective organizational structures to respond

to patient concerns. It features a combination of traditional and innovative learning approaches as well as small group discussions.

Applied Quality in Health Care Settings

This course focuses on changes and best practices to combat known risks in health care today. These include approaches to hospital-acquired conditions, as well as systematic interventions to recognize and minimize harm both in hospital and ambulatory

settings and between. Strategies to support a culture of safety, including spreading knowledge, teamwork training, and managing unprofessional behavior are explored.

The advanced content discusses system interventions to improve the quality of care. Topics such as value, the patient experience, and health care disparities as measures of quality are explored.

Leadership and Teamwork

The process of change is not simple in health care environments. Systems are complex, and stakeholders have different individual needs. This course provides an overview of leadership concepts that are most relevant to safety and quality and the cultures that leaders need to establish. These include foundational concepts in change management, negotiation and consensus-building, making a financial case for quality and safety, and managing teams for improvement.

Special and Emerging Topics in Safety and Quality

Safety and quality operations are continuing to evolve as the field grows. This course will present focused primers in two fields: implementation science and population health. In addition, students will have

the opportunity to explore emerging concepts, such as emotional harm to providers and patients, safety implications of provider burnout, and techniques to train team members in quality and safety.