title: Building a safer foundation: the Lessons Learnt patient safety training programme.
abstract: OBJECTIVE
  To develop, implement and evaluate a novel patient safety training programme for junior doctors across a Foundation School-'Lessons Learnt: Building a Safer Foundation'.
  
  
  METHODS
  Prospective preintervention /postintervention study across 16 Foundation Programmes in North West England, UK. 1169 participants including all Foundation Programme Directors, Administrators, Foundation trainees and senior faculty.
  
  
  METHODS
  Half-day stakeholder engagement event and faculty development through recruitment and training of local senior doctors. Foundation trainee-led monthly 60-min sessions integrated into compulsory Foundation teaching from January to July 2011 comprising case-based discussion and analysis of patient safety incidents encountered in practice, facilitated by trained faculty.
  
  
  METHODS
  Participants' satisfaction and Foundation trainees' patient safety knowledge, skills, attitudes and behavioural change.
  
  
  RESULTS
  Participants reported high levels of satisfaction with 'Lessons Learnt'. There was a significant improvement in trainees' objective patient safety knowledge scores (Meanpreintervention=51.1%, SD=17.3%; Meanpostintervention=57.6%, SD=20.1%, p<0.001); subjective knowledge ratings and patient safety skills. Trainees' perceived control and behavioural intentions regarding safety improved significantly postintervention. Feelings and personal beliefs about safety did not shift significantly. Trainees reported significantly more patient safety incidents in the 6 months following introduction of 'Lessons Learnt' (Meanpreintervention=0.67, SD=1.11; Meanpostintervention=1.18, SD=1.46, p<0.001). 32 quality improvement projects were initiated by trainees, spanning the development of novel clinical protocols; implementation of user-informed teaching and improved rota design
  
  
  CONCLUSIONS
  Patient safety training can be implemented and sustained to deliver significant improvements in patient safety knowledge, skills and behaviours of junior doctors-with potential for wider positive organisational impact. Medical education commissioners and providers could adopt and build upon the 'Lessons Learnt' approach as a springboard to promote medical engagement in quality and safety improvement.
authors.affiliation: Department of Surgery and Cancer, Imperial College London, , London, UK.
authors.forename: Maria
authors.initials: M
authors.lastname: Ahmed
authors.forename: Sonal
authors.initials: S
authors.lastname: Arora
authors.forename: Stephenie
authors.initials: S
authors.lastname: Tiew
authors.forename: Jacky
authors.initials: J
authors.lastname: Hayden
authors.forename: Nick
authors.initials: N
authors.lastname: Sevdalis
authors.forename: Charles
authors.initials: C
authors.lastname: Vincent
authors.forename: Paul
authors.initials: P
authors.lastname: Baker
mesh_terms: D005178:Faculty; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007318:Inservice Training; D007398:Interpersonal Relations; D019300:Medical Errors / Q000517:prevention & control / Q000706:statistics & numerical data; D010043:Outcome and Process Assessment, Health Care / Q000379:methods*; D061214:Patient Safety; D010820:Physicians / Q000523:psychology / Q000592:standards*; D018794:Problem-Based Learning; D016730:Program Development; D015397:Program Evaluation; D011446:Prospective Studies; D013192:Staff Development; D056164:Teaching Rounds; D006113:United Kingdom
keywords: Medical education; Patient safety; Quality improvement; Root cause analysis