The Outcomes Card

Introduction: The Accreditation Council for Graduate Medical Education requires competence in systems‐based practice (SBP) demonstrating understanding of complex interactions between systems of care and its impact upon care delivery. Patient safety is a useful vehicle to facilitate learning about these interactions. Aim: Develop an educational tool, Outcomes Card (OC), to reinforce core concepts of SBP. Setting: Urgent Care Center at Louis Stokes Cleveland Department of Veterans Affairs Medical Center. Program Description: Pilot study of an educational intervention for residents that included patient safety didactic sessions and analysis of 2 self‐identified clinical cases using the OC. Residents entered the following information on the OC: case description, type of event (error, near miss, and/or adverse event), error type(s), systems, and system failures. Program Evaluation: Two reviewers independently analyzed 98 cards completed during 60 two‐week trainee rotations (81.7% return rate). Interrater reliability for error types between residents and physician supervisor and between reviewers was excellent (κ=0.88 and 0.95, respectively), and for system identification was good (κ=0.66 and 0.68, respectively). The self‐assessment survey (56.6% return rate) suggests that residents improved their knowledge of patient safety and had positive attitudes about the curriculum. Discussion: This pilot study suggests that OCs are feasible and reliable educational tools for enhancing competence in SBP.