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Developing the University of Tartu to a well-networked PATient SAFEty research center in Estonia

Periodic Reporting for period 1 - PATSAFE (Developing the University of Tartu to a well-networked PATient SAFEty research center in Estonia)

Reporting period: 2019-09-01 to 2020-11-30

Patient safety incidents in healthcare are a common phenomenon, which affects all countries worldwide. Estimates show that 1/10 patients are harmed during hospital care resulting in 23 million disability-adjusted life years lost per year. There is still few evidence about the patient safety in Estonia and research in this area is needed. The PATSAFE project will enhance Institute of Clinical Medicine of the University of Tartu (ICM-UT) research potential and capacities in patient safety in order to improve and strengthen knowledge and skills in methods, techniques and experience for patient safety research. Strategic partnership with Avedis Donabedian Foundation from Spain and IQ Healthcare from The Netherlands, both international leaders in patient safety research, enables developing a long-lasting knowledge exchange alliance allowing ICM-UT to capitalize on its current achievements and overcoming gaps in scientific excellence in the field of patient safety research.
The general objective of the PATSAFE project is to improve and strengthen research excellence of the ICM-UT in the field of patient safety research among the early-stage researchers (ESRs) and staff with a special focus on the improvement of knowledge and skills in methods, technics and experience for patient safety research.
PATSAFE will substantially and measurably improve scientific and innovation capabilities and performance of ICM-UT in patient safety research methodology, and thereby positively impact the overall health care quality and patient safety research and innovation performance of Estonia. Increasing Estonian research capabilities and performance on patient safety will enable researchers to investigate the magnitude and nature of patient harm in Estonia and, ultimately contribute to promoting the development of evidence-based strategies and evaluation of the effectiveness of potential solutions. This approach will eventually decrease the burden on healthcare-caused harm to the loss of capacity and productivity of patients being harmed, and to the loss of trust in the health system and leads to additional free resources within the health system.

The PATSAFE project has a high impact on the overall quality and safety of health services: improved knowledge in patient safety research will improve the safety of health services on the individual and population level by providing evidence-based strategies. In this project, ICM-UT will bring together national and international experts to exchange knowledge and experience, and thereby maximise the impact of the research for the benefit of the patients and clients of the health system.
Most of the efforts during the first project period were related to the development of the curriculum on training in the research methodology applied for patient safety research. This unique and comprehensive curriculum covers relevant areas in patient safety research and consists of three modules:

1) Fundamentals in patient safety (4 courses):
• The science of patient safety and burden of unsafe care
• Methods of analysis of adverse events and improvement of patient safety (I)
• Methods of analysis of adverse events and improvement of patient safety (II)
• Implementation science and patient safety improvement.

2) Patient safety culture and patient involvement in patient safety research (5 courses):
• Patient safety culture
• Patient involvement in patient safety and patient safety research
• Validation techniques of measurement tools to study patient safety culture in healthcare settings in Estonia
• An introduction on literature reviews
• An introduction to qualitative research.

3) Development of soft skills to support the implementation of patient safety research in practice (4 courses):
• Research proposal
• Research ethics
• Intellectual property rights and commercialization in research
• Human resources and change management in clinical settings.

Currently, six of 13 courses have been launched, and three courses will be launched in March 2021. The last four courses will be carried out during 2021. At present, about 50 participants are enrolled in different courses, of them, 20 have completed at least one course.
Depending on the participant’s background and needs, there is an option to choose between the basic and advanced level course.
We have organised the meeting with the project team and the representatives of the stakeholders to understand the stakeholders’ expectation regarding the research in patient safety and agreed about the creation of the Estonian Patient Safety Research network. We have created the website including the overview of the project aims, the content of work packages, training program and description of the courses as well the overview about the media coverage of the project-related activities. So far, the PATSAFE project had more than 20 media reflections in total, most of them in Estonia.
We have submitted three abstracts in two international conferences, of them two were accepted for poster presentation in ISQua annual conference (expected to be held in Florence, Italy, 8-11 July of 2021). The decision about the acceptance of the abstract for the poster presentation in International Forum for Quality and Safety in Healthcare (expected to be held in London, 21-23 April 2021) is still pending. We also started discussions about drafting the manuscripts about the PATSAFE project and its progress for submission in the international peer-reviewed journals.
In September 2020, we started with the drafting of the institutional strategy of patient safety research for the University of Tartu. The drafting of the institutional strategy for patient safety research is in progress, and is expected to be ready by the end of February 2021.
We have developed a unique patient safety research training program including the specific modules as well the module for the development of soft skills. Our target group is rather heterogeneous regarding the knowledge and skills including senior academic staff, PhD students/ESRs as well the practitioners who will help the researchers in data collection and will implement the results of the research into practice. Thus, we revised the original training program and developed two versions of the training courses allowing: a basic (0.5-1 ECTS) and an advanced (2-2.5 ECTS). Until the end of the project, we expect that we will achieve the objective regarding the number of trained persons among the academic staff as well the ESRs.

The strategy development process is a good opportunity to agree with institutional and national research priorities in patient safety as well to associate the people interested in patient safety from different organizations. The ICM-UT as the single academic medical center in Estonia has a significant impact on the development and implementation of clinical risk and patient safety management systems, both through the educating the students and health professionals as well involving the practitioners in the research. The ICM-UT staff members participating in the PATSAFE training program have started to implement new knowledge in the under- and postgraduate medical and nursing training. Participation in the research training has encouraged the practitioners to start with the research and to continue their carrier as PhD students. Thus, new knowledge and skills will spread beyond the academic society and reach the practitioners.
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