Aiming to control the incidence of medical errors, the Dana-Farber Cancer Institute (DFCI) in Boston created a three-month patient-oriented team training campaign using out-of-industry principles to empower ambulatory patients and their families to actively pursue safe care.
A February 2009 article in the Joint Commission Journal of Quality and Patient Safety summarizes a high performance team training environment adapted to an oncology clinical environment. Oncology care is often delivered in multispecialty teams and with the patient's and family's active involvement. To examine the potential value of a patient-oriented teamwork intervention, a teamwork training initiative for oncology patients and their families was developed at the Dana-Farber Cancer Institute.
Developing the Campaign: The content and format of the initiative evolved iteratively on the basis of several core team-training concepts derived from the research literature in health care and aviation. Initially a targeted intervention, the program evolved into a multifaceted campaign that included internal marketing, staff training, and one-on-one patient outreach by a group of volunteers. The You CAN campaign sought to convey a positive and empowering message that encouraged patients to (1) check for hazards in the environment, (2) ask questions of clinicians, and (3) notify staff of safety concerns.
Implementing the Campaign: The You CAN campaign was conducted from July through September 2007. To assess its progress, patients were surveyed at baseline and during the campaign. On the basis of the survey results, 32% (95% confidence interval [CI]: 25%-38%) of the ambulatory clinic population, or 1,145 patients, were exposed to the campaign. Although patients rated the quality of teamwork and communication favorably at both baseline and follow-up, there was no significant change in the self-reported use of teamwork techniques on a written survey. However, 39% (95% CI: 27%-51%) of those who were exposed to the campaign said that it changed their behavior.
Discussion: A training program for patients and their families is feasible in ambulatory oncology and may be applicable to other clinical settings.