Resources

​Resources and tools to help you improve patient safety.
Videos
How Have Computers Changed Patient-Provider Relationships?
In a new video, patient safety expert Dr. Bob Wachter explores how computers have changed patient-provider relationships.
What Are the Dangers of Alert Fatigue?
In a new IHI Open School short, patient safety expert Dr. Bob Wachter talks about the dangers of alert fatigue in health care.
Why Is Psychological Safety So Important in Health Care?
Why is psychological safety in health care so important? In a short video, Amy Edmondson, Novartis Professor of Leadership and Management at Harvard Business School, describes four specific outcomes associated with a psychologically safe work environment.
Three Ways to Create Psychological Safety in Health Care
How can leaders ― with or without formal authority ― create psychological safety in health care? In a short video, Amy Edmondson, Novartis Professor of Leadership and Management at Harvard Business School, describes three key actions to foster a psychologically safe work environment.
How Can You Apply Clinical Skills to QI?
MIT senior lecturer and IHI Senior Fellow Steve Spear explains why he thinks seven steps needed to care for patients are essentially the same as those needed to fix systems of care. He also shares common trouble areas and gives an example of a successful improvement.
What Happened to Josie?
In 2001, 18-month-old Josie King died of dehydration and a wrongly-administered narcotic at Johns Hopkins Hospital. How did this happen? Her mother, Sorrel King, tells the story and explains how Josie’s death spurred her to work on improving patient safety in hospitals everywhere.
Why Do Errors Happen? How Can We Prevent Them?
Millions of people suffer every year from mistakes in health care. Lucian Leape explains why those mistakes happen — and how to prevent them.
Learning from Medical Errors (Part 2)
A baby falls gravely ill after a botched blood transfusion. A student nearly commits a medication error. A patient dies after a clumsy surgery. In this video, current and former clinicians (including IHI’s Former CEO Don Berwick) describe the errors that still haunt them today — and point out ways those errors could have been prevented.
Learning from Medical Errors (Part 1)
A patient suffers horrible burns. An operation takes twice as long as it should. A child dies from internal bleeding. All because a doctor, a nurse, or another care provider made a mistake. In this video, prominent clinicians describe the errors that still haunt them today — and point out ways those errors could have been prevented.
The Patient and the Anesthesiologist
Linda Kenney went into the hospital for an ankle replacement. She came out with a host of complications resulting from a mistake that no one was willing to admit. Until Rick Van Pelt, MD, her anesthesiologist, stepped forward. In this three-part video case study, you’ll find out what happened in the immediate aftermath of the surgery, watch Kenney and Van Pelt describe their first meeting after the surgery, and watch Kathy Duncan, RN, and Don Berwick, MD, analyze the case.
How Can Data Drive Reliability? (Part 5 of 5)
IHI Executive Director Frank Federico discusses the role of measurement and the role of leadership in achieving reliable designs.
What Is the Goal of Reliable Design? (Part 3 of 5)
IHI Executive Director Frank Federico explains the goal behind reliable design — and why capability is just as important as reliability.
Why Do You Need a Back-Up Plan? (Part 4 of 5)
IHI Executive Director Frank Federico discusses why and when to create a back-up plan for a reliable process.
How Can You Make Processes Reliable? (Part 2 of 5)
IHI Executive Director Frank Federico discusses steps you can take to make your processes more reliable.
What Is Reliability? (Part 1 of 5)
IHI Executive Director Frank Federico provides an introduction to reliability, including a definition, some examples, and components of IHI’s proven methodology.
Disruptive Behavior: The Arterial Stick
A resident tells a medical student to do a blood gas on a patient. The student says, “I don’t know how.” The resident is annoyed – and he says something that he’ll regret for years. Physician Ron Wyatt reflects on what he said (and wishes he had said) to the student.
How Can Disruptive Behavior Be Harmful?
Physician Kevin Stewart explains how he accidentally hurt a patient when he was trying to avoid a confrontation with his foul-tempered supervisor. He offers advice for people who find themselves on the receiving end of disrespectful behavior.
Disruptive Behavior: A Slap on the Hand
When you’re rude and disrespectful to your co-workers, you put your patients at risk. In this video, former nurse Jill Duncan recalls watching a senior nurse bully a medical resident. She explains why this behavior happens, and how you should respond if you’re on the receiving end.
Why Is Reducing Harm — Not Just Error — Important to Patient Safety?
Dr. David Bates, a world renowned patient safety expert, explains why the field of patient safety has shifted from reducing error to also encompass efforts to reduce harm.
How Do You Apologize After a Medical Error?
When you make a mistake that affects a patient, what should you say? Should you apologize, or will that put you at greater risk of being sued? Lucian Leape, MD, Adjunct Professor of Health Policy at the Harvard School of Public Health, describes how to talk with patients and families after a mistake has occurred.
What Is a Culture of Safety?
Dr. David Bates, a world-renowned patient safety expert, describes a culture of safety and what organizations can do to foster it.
What Can a Zoo Teach Health Care about Patient Safety?
Kathy Duncan goes behind the scenes to learn about the Central Florida Zoo's safety procedures for handling snakes.
Why Should Providers Talk to Patients after Adverse Events?
Lewis Blackman, a healthy 15-year-old boy, died in 2000 after an elective surgery. In this video, Helen Haskell, his mother, explains why providers should communicate with patients and families after adverse events.
What Is the Long-Term Impact of Adverse Events on Patients?
Lewis Blackman, a healthy 15-year-old boy, died in 2000 after an elective surgery. In this video, Helen Haskell, his mother, gives an example of the long-term impact of adverse events on patients and families.
Why Don’t Providers Always Communicate with Patients after Adverse Events?
Lewis Blackman, a healthy 15-year-old boy, died in 2000 after an elective surgery. In this video, Helen Haskell, his mother, explains why communication isn’t always the norm after adverse events, and why this dynamic is changing.
What Is Your Advice for Providers about Communicating with Patients After Adverse Events?
Lewis Blackman, a healthy 15-year-old boy, died in 2000 after an elective surgery. In this video, Helen Haskell, his mother, offers advice for providers who are involved in adverse events about how they should communicate with patients and families.
Why Patient Safety Is at the Top of the List
In 2001, the National Academy of Science’s Institute of Medicine (IOM) laid out six dimensions of quality for health care. According to the IOM, care should be safe, effective, patient-centered, timely, efficient, and equitable. Carol Haraden, patient safety expert, tells us why safety is at the top of that list.
Meet the Students: Desiree de la Torre
Desiree de la Torre’s grandfather acquired an infection in a hospital. Now, Desiree, a recent business school graduate, wants to ensure that other patients have a better experience.
Josie's Story
Eighteen-month-old Josie King died from medical errors incurred at Johns Hopkins Hospital. Her mother, Sorrel King, later worked with hospitals to develop a way for patients and their families to summon a Rapid Response Team to the bedside within minutes.
Improving the Health Care of an Entire Country
Is it possible to cut adverse events by 30 percent – and hospital mortality by 15 percent – across an entire country? The Scottish Patient Safety Programme (SPSP) is an ambitious attempt to do just that.
What Is It Like to Experience a Medical Error?
Get an inside look at a patient's perspective through the personal story of Linda Kenney, President of Medically Induced Trauma Support Services.

Loading Pages....

first last

Loading Pages....

first last

Loading Pages....

first last

Loading Pages....

first last