A Culture of Safety From Day 1: An Institutional Patient Safety Initiative to Support Incoming Interns

Lead author: Kinga L. Eliasz, PhD
Submitted by: Janice Radway, Perelman School of Medicine at the University of Pennsylvania

On the first day of residency, incoming interns must understand the specific ways their new institution creates a culture of safety. To support transitioning trainees, this group at NYU Langone Health developed an authentic, large-scale immersive patient safety simulation called First Night-on Call (FNOC). This is a 4-hour immersive simulation during which new interns, in groups, were challenged to conduct an ethical informed consent, activate a rapid response team (escalation), document a clinical encounter, conduct an effective patient handoff, and participate in patient safety rounds.

Post-FNOC, more than 94% of interns reported increased comfort in speaking to a supervisor, escalating a situation, and reporting a medical error. Engaging, immersive, innovative, simulation-based group experiences like FNOC may reduce the variability seen in incoming interns and instill aspirational institutional norms—generating a culture of safety and providing a framework for effective on-boarding strategies for novice health care providers.

Read more about the program here.

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