WIHI: Always Events: Raising Expectations for Patient Experience​

Date: September 8, 2011


  • Lucile O. Hanscom, Executive Director, Picker Institute
  • Dale Shaller, MPA, Principal, Shaller Consulting Group
  • Martha Hayward, Lead for Public-Patient Engagement, Institute for Healthcare Improvement
  • Gaye Smith, Chief Patient Experience and Service Officer, Vanderbilt University Medical Center
  • Anthony M. DiGioia, MD, Founder, The Orthopaedic Program and Innovation Center, Magee-Womens Hospital of UPMC

Most of us are familiar with the National Quality Forum’s list of Serious Reportable Events in health care — often referred to as “Never Events.” There’s a wide consensus that everything from performing surgery on the wrong patient or wrong site, to a medication error-induced death, to a physical assault aren’t only tragic and harmful, they are not supposed to happen. Period. It’s a strong statement about patient safety and what the system as a whole should not be willing to tolerate. And, by extension, it’s a call to action to do better and to take care of patients differently so that terrible things do not occur.  

There are, of course, many ways to draw a line in the sand or to envision the health care system patients deserve and that providers want to work in. One of the most innovative in the last few years has been the Picker Institute’s development of a concept they’ve dubbed “Always Events®.” First conceived in 2009, Always Events® are activities and processes that should routinely be part of patient care and the patient and family experience, to ensure optimal communication, discharge, handoffs, transitions, health literacy, and more.

WIHI welcomes the Picker Institute’s Executive Director, Lucile Hanscom; consultant Dale Shaller, who has an extensive history developing benchmarks and measurement systems for patient-centered care; Martha Hayward, who has been working with IHI to help shape public and patient engagement, drawing on her own history as a patient and as a strong and effective leader in Massachusetts; and dynamic leaders from two organizations that have received Always Events Challenge Grants: Gaye Smith of Vanderbilt University Medical Center and Tony DiGioia of the University of Pittsburgh Medical Center (UPMC).

Dr. DiGioia’s groundbreaking improvements at UPMC are anchored in a first of its kind patient- and family-centered methodology. Picker’s support is helping to integrate these processes into the hospital’s transplant program. The grant-funded work at Vanderbilt, under Gaye Smith, is targeting better communication and collaboration between patients, family members, and providers to prevent patient falls during hospital stays.



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