​More Information

For questions or more information about which IHI Onsite Diagnostic is best suited for your organization’s needs, please email: DiagnosticsOfferings@ihi.org

Improving Patient Safety across a System Onsite Diagnostic

Expert Analysis and Recommendations

IHI’s Improving Patient Safety across a System Onsite Diagnostic lays out a clear path to improving patient safety throughout a system.

With a team of experienced senior leaders, IHI will come to your organization to assess current assets within your system and any existing barriers to safety and improvement.

This diagnostic may be tailored to the needs and priorities of your system.



  • Provide actionable strategies for closing identified gaps in safe care, based on what is learned via the diagnostic about current organizational culture, strategy, policies, priorities, and assets, and existing barriers to safety and continuous improvement
  • Inform priority actions for implementing a comprehensive and effective framework for patient safety, and for building capacity, capability, and the cultural foundation to promote and sustain safe care and quality improvement
  • Identify two to four key opportunity areas for concentrated activity to achieve initial and lasting results with patients and families



This diagnostic utilizes an IHI framework for system-wide safety that focuses on two key components: a learning system and organizational culture. We use the framework to understand a health system’s existing assets and safety and quality improvement capabilities, and then identify specific recommendations for attaining system-level safety goals and building a system-wide culture centered on safety and quality improvement.

In collaboration with your organization, a team of IHI experts leads a high-level diagnostic process using the framework, organized around nine domains for optimal performance:

  • Leadership: Facilitating teamwork, improvement, respect, and psychological safety
  • Psychological Safety: Creating an environment where people feel comfortable and have opportunities to raise concerns or ask questions
  • Accountability: Being held accountable to act in a safe and respectful manner, given the training and support to do so
  • Teamwork and Communication: Developing a shared understanding, anticipation of needs and problems, and agreed-upon methods to manage daily teamwork as well as conflict situations
  • Engagement: Gaining genuine agreement on matters of importance to team members, patients, and families
  • Continuous Learning: Regularly collecting data on and learning from care process defects and successes
  • Improvement and Measurement: Improving work processes and patient outcomes using standard improvement tools, including measurement over time 
  • Reliability: Applying the best evidence to provide safe and reliable care, and minimizing non-patient-specific variation, with the goal of failure-free operation over time
  • Transparency: Openly sharing data and other information concerning safe, respectful, and reliable care with staff, patients, families, and other key stakeholders

Underlying the entire framework is a focus on patient and family engagement, thus the diagnostic also helps identify opportunities to partner with patients and families for improvement.


Onsite Process

Below is a general overview of the sequence of steps during the diagnostic period:

  • Virtual or In-Person Meeting with Leadership Teams
  • Pre-Visit Data Collection and Relevant Information Gathering
  • Pre-Visit Planning Call with Leadership Teams
  • On-Site Visit(s) by the IHI diagnostic team to meet with key stakeholders and conduct field observations
  • Findings and Recommendations presented via an in-person debrief, as well as a written report


Findings and Recommendations

The findings and recommendations provided by IHI at the conclusion of the diagnostic are intended to be actionable and help senior leaders further shape strategy and plans for executing on the strategy.

The diagnostic is often a starting point for a deeper engagement with IHI to achieve system-wide transformation. Please see Customized Services for an overview of how organizations can further engage with IHI to effect change in their systems.