Resar RK. Making noncatastrophic health care processes reliable: Learning to walk before running in creating high-reliability organizations. Health Services Research. 2006 Aug;41(4 Pt 2):1677-1689.

This article describes the Institute for Healthcare Improvement's (IHI) current approach to improving health care reliability, including a useful nomenclature for levels of reliability, and a focus on improving reliability of basic health care processes before moving on to more sophisticated high-reliability organization concepts. [Part of a special issue series.]

Reinertsen JL, Clancy C. Foreword to: Keeping our promises: Research, practice, and policy issues in health care reliability. A special issue of Health Services Research. 2006 Aug;41(4 Pt 2):1535-1538.

This special issue, funded by the Agency for Healthcare Research and Quality, examines aspects of health care reliability and improving the performance of our health systems to provide reliable, safe, evidence-based care. This foreword describes three broad categories for articles in the series: how principles of reliability can address the problem of not harming patients; organizational culture and reliability; and the translation of reliability theory into practice.

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Shannon RP, Frndak D, Grunden N, et al. Using real-time problem solving to eliminate central line infections. Joint Commission Journal on Quality and Patient Safety. 2006 Sep;32(9):479-487.

This article describes how two intensive care units (ICUs) redefined the processes of care through system redesign to deliver reliable outcomes. The ICUs implemented Toyota Production System principles to central line placement and maintenance, and within a year CLABs decreased from 49 to 6 (10.5 to 1.2 infections/1,000 line-days). Mortality also decreased from 19 to 1 (51 percent to 16 percent) despite an increase in the use of central lines and number of line-days.

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Raising the bar with bundles: Treating patients with an all-or-nothing standard. Joint Commission Perspectives on Patient Safety. 2006 Apr;6(4):5-6.

A "bundle" is a collection of processes needed to effectively and safely care for patients undergoing particular treatments with inherent risks. Several interventions are "bundled" together and, when combined, significantly improve patient care outcomes. This article describes the Ventilator Bundle, Central Line Bundle, and Sepsis Bundles developed by the Institute for Healthcare Improvement and others, and explains how organizations can improve clinical outcomes by using care bundles.

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Donohue MA. Best-practice protocols: Evidence-based care for acute myocardial infarction. Nursing Management. Aug 2005;36(8):23-27.

Through its performance improvement service lines, Hackensack University Medical Center first reduced, and then eliminated, the occurrence of cardiac-related, inadequate “handoff,” defined as delays in getting the right treatment to the patient at the right time. The medical center is spreading interventions that have fostered safe and reliable care to patients, including care for patients experiencing acute myocardial infarction. This article is part of a series that describes the Institute for Healthcare Improvement's 100,000 Lives Campaign recommended interventions from a nursing management perspective.

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Lackey SA. Suppressing the scourge of AMI. Nursing2006. 2006 May;36(5):36-41.

Acute myocardial infarction (AMI) affects 1.1 million people each year, and about 350,000 of them die in the acute phase. Because reliable evidence-based care reduces AMI mortality, IHI’s 100,000 Lives Campaign emphasizes the importance of recommendations in the American Heart Association (AHA)/American College of Cardiology (ACC) guidelines. In this article, the author, from Moses Cone Health Care System in Greensboro, North Carolina, explains the processes that lead to AMI, provides details from the AHA/ACC guidelines, and highlights the ACC’s seven components of care that save lives.

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Institute for Healthcare Improvement. IHI Innovation Series white paper. Improving the Reliability of Health Care. Boston, Massachusetts: Institute for Healthcare Improvement; 2004.

IHI Innovation Series white paper

This white paper describes principles and strategies used successfully in other industries to help evaluate, calculate, and improve the overall reliability of complex systems, and explains the application of reliability principles to health care.

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Wilkins DJ. The Bathtub curve and product failure behavior part two – Normal life and wear out. Reliability Hotwire: The eMagazine for the Reliability Professional [serial online]. December 2002; issue 22.

This second article of a two part series, describes the bathtub curve, a graphical representation used by reliability experts to describe the lifetime of a product population.  The author uses the product failure distribution to depict failure rates at different stages along the curve and goes on to describe some solutions to these failure modes.  The Institute for Healthcare Improvement is using this concept to advance its thinking on improving reliability in five key clinical areas.

Wilkins DJ. The Bathtub curve and product failure behavior part one - The Bathtub curve, infant mortality and burn-in. Reliability Hotwire: The eMagazine for the Reliability Professional [serial online]. November 2002; issue 21.

This first article of a two part series, describes the bathtub curve, a graphical representation used by reliability experts to describe the lifetime of a product population.  The author uses the product failure distribution to depict failure rates at different stages along the curve and goes on to describe some solutions to these failure modes.  The Institute for Healthcare Improvement is using this concept to advance its thinking on improving reliability in five key clinical areas.

Weick KE, Sutcliffe KM
San Francisco, California: Jossey-Bass; 2001

Describes how high reliability organizations (HROs) perform efficiently in high stress situations. The authors demonstrate how to respond to tough challenges using tools they describe and explain.