Work-integrated learning for improving patient centered care, efficiency and quality

Objectives: Healthcare employers across the world are concerned about the ability of educational systems to nurture a qualified workforce with necessary quality and safety attributes for healthcare professionals. A core requirement of health leaders is to be able to change and adapt the system to meet the changing needs of patients. In the tertiary education sector there is an identified lack of courses available in health service improvement methodologies combined with an evidence-based work-integrated learning (WIL) approach. To fill this gap in Australia, the NSW Agency for Clinical Innovation (ACI) and University of Tasmania provide a practically focused Graduate Certificate (Clinical Redesign) (Program). The course content is designed to step students through a strategically significant health service improvement initiative, delivered within their own workplace focussing on improving and innovating patient centred care.

Methods: A largely quantitative research approach has been used to evaluate the impact of the Program. The study aimed to assess course outcomes for impact and effectiveness. The study used a questionnaire measuring outcomes, via a Likert Scale, multiplechoice questions and open questions. The questions were adapted from previous validated surveys aimed at undergraduate and postgraduate students completing university study. The study was approved by the Tasmanian Human Research Ethics Committee. SPPS software was used to analyse the data.

Results: This study was specifically designed to capture the experiences of students undertaking work-place learning and their mentors and sponsors. The survey had 99 respondents and the results were a resounding endorsement of the program. The outcomes of the program are multifaceted as students increased capacity to: i) identify workplace issues and use data/evidence to build a case for change (84 % strongly agreed); and ii) evaluate changes made to health service delivery (67% strongly agreed). The Program has equipped students to implement healthcare improvements (77% strongly agreed) and increased students’ capacity to work with others to facilitate change in their organisation (83% strongly agreed). Students have been able to transfer their skills to others in the workplace (58% strongly agreed) and lead further health improvement projects (55% strongly agreed). Students’ solutions have been adopted elsewhere in their organisation (40% strongly agreed). Students reported that the Program has led to better patient outcomes within organisations (87% agreed) and improvements to the way care is delivered have been made in organisations as a result of the Program (93% agreed).

Conclusion: Combining tertiary education with work-integrated learning, designed specifically for healthcare professionals and with industry, is an important investment. The most important aspect of delivering the Program, in our opinion, is the WIL component. Our study suggests it is key to developing patient centred services, while improving the quality, safety and efficiency of care delivery. An essential feature of the Program is that it can be delivered to a wide variety of healthcare services, such as primary health, outpatient departments and mental health as well as acute care, highlighting its pivotal role across the entire healthcare spectrum. Our presentation will inspire others to consider a WIL approach to build capability for health service improvement.