Quality and safety education: foreground and background.

Since 1988, Case Western Reserve University (CWRU), through its School of Medicine, Frances Payne Bolton School of Nursing, and Division of Public Health, has committed to the development and implementation of quality improvement and safety education as a formal part of its health professions curriculum. Faculty moved quality and safety education from the "background" of implicit learning to the "foreground" of established curriculum. The transformation has affected not only course content but also many academic careers in the process. This article highlights 3 of the many quality and safety education activities that have evolved at the CWRU: the graduate-level course on quality improvement, medical student education, and doctoral education. Based on these activities, 4 key elements are presented as essential for a successful and sustainable quality and safety education program: quality improvement role models and champions, strong academic-practice partnerships, a variety of educational modalities, and a supportive learning environment.