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Invite the Next Generation to Lead
Reflecting on lessons from 10 years of the IHI Open School, this article shares five practical ideas for how can health care organizations can engage the next generation of health professionals as powerful change agents and leaders.
Transforming Concepts in Patient Safety: A Progress Report
This article reviews progress to date to advance patient safety in the US in five essential areas of health care, as first identified in 2009 by the IHI/NPSF Lucian Leape Institute.
Leadership and Vision for a Culture of Safety
Leaders seeking to transform their health care organization’s culture would do well to commit focused attention on six key areas described in this article.
No Place Like Home: Advancing the Safety of Care in the Home
This report provides expert panel recommendations, strategies, and tools for realizing five guiding principles for advancing the safety of home care.
The Scottish Improvement Journey: A Nationwide Approach to Improvement
Learn about Scotland’s 10-year effort to apply quality improvement on a national scale to improve patient safety, including an in-depth review of the successful Scottish Patient Safety Programme, and further QI efforts that spread across Scotland into new social policy areas such as children’s services, education, and justice.
Integrating Behavioral Health in the Emergency Department and Upstream
This IHI Innovation Report discusses barriers to integrating behavioral health in the ED, and presents five drivers (emerging from six key themes from existing approaches) that form the building blocks of a theory of change for making improvements in this area.
Transforming Health Care: A Compendium of Reports from the NPSF Lucian Leape Institute
A guide for health care leaders in assessing where their organizations stand in the journey to safer care and what steps they can take to make greater progress.
Shining a Light: Safer Health Care Through Transparency
This Lucian Leape Institute report offers sweeping recommendations to bring greater transparency in four domains: between clinicians and patients; among clinicians within an organization; between organizations; and between organizations and the public. It makes the case that true transparency will result in improved outcomes, fewer medical errors, more satisfied patients, and lowered costs of care.
Safety Is Personal: Partnering with Patients and Families for the Safest Care
This Lucian Leape Institute report is a call to action for health leaders, clinicians, and policy makers to take the necessary steps to ensure patient and family engagement at all levels of health care. It identifies specific action items for health leaders, clinicians, and policy makers to pursue in making patient and family engagement a core value in the provision of health care.
Through the Eyes of the Workforce: Creating Joy, Meaning, and Safer Health Care
This Lucian Leape Institute report details how workplace safety is inextricably linked to patient safety. It highlights vulnerabilities common in health care organizations, discusses the costs of inaction, outlines what a healthy and safe workplace would look like, and offers seven recommendations for actions that organizations need to pursue to effect real change.
Order from Chaos: Accelerating Care Integration
Too often, care integration — the planned, thoughtful design of the care process for the benefit and protection of the patient — is lacking. This Lucian Leape Institute report addresses the issue of care integration with the aim of outlining the major barriers to effective integration and providing a framework for further consideration and action among stakeholders.
Unmet Needs: Teaching Physicians to Provide Safe Patient Care
Unmet Needs is the culmination of three Lucian Leape Institute roundtable discussions and makes key recommendations for reforming medical education in order to improve patient safety. The paper was the first in a series of such reports on issues identified as top priorities in ongoing efforts to improve patient safety.
Leading a Culture of Safety: A Blueprint for Success
Creating a culture of safety in health care settings has proven to be a challenging endeavor, and there is a lack of clear actions for organizational leaders to take in developing such a culture. This guide provides chief executive officers and other health care leaders with a useful tool for assessing and advancing their organization’s culture of safety, and can be used to help determine the current state, inform dialogue with the board and leadership team, and help leaders set priorities.
Is Your Organization Highly Reliable?
This article presents common high-reliability organization (HRO) characteristics that apply to all health care organizations seeking to improve patient safety, and cross-walks them with the IHI Framework for Safe, Reliable, and Effective Care to help leaders build a culture and learning system to support HRO characteristics and safer systems of care.
Free from Harm: Accelerating Patient Safety Improvement Fifteen Years after To Err Is Human
This report assesses the state of patient safety in health care, advocating for a total systems approach across the continuum of care and establishment of a culture of safety, and calling for action by government, regulators, health professionals, and others to place higher priority on patient safety improvement and implementation science.
Measuring Patient Safety in Real Time: An Essential Method for Effectively Improving the Safety of Care
The continuing evidence of preventable deaths due to medical error has led to recent calls to improve measurement of safety in hospitals. This need can be adequately addressed by harnessing health information technology.
Closing the Loop: A Guide to Safer Ambulatory Referrals in the EHR Era
The recommendations outlined in this publication are designed to help standardize the ways in which primary care practitioners activate referrals to specialists, and then keep track of the information over time. It describes a nine-step, closed-loop process in which all relevant patient information is communicated to the correct person through the appropriate channels and in a timely manner.
10 IHI Innovations to Improve Health and Health Care
This curated publication highlights 10 ideas that have emerged from IHI's systematic 90-day innovation approach, including reflections on the Triple Aim, the concept of a health care Campaign, the Breakthrough Series Collaborative model, and other frameworks and fresh thinking that have been replicated around the world.
Reducing Inappropriate Medication Use by Implementing Deprescribing Guidelines
This case study from the IHI/Commonwealth Fund International Program for US Health Care System Innovation describes how a multidisciplinary team of clinical experts in Ottawa, Canada, created a credible, low-cost process for developing and implementing evidence-based deprescribing guidelines and tools for assessing, tapering, and stopping medications that may cause harm or no longer benefit patients.
Nature of Blame in Patient Safety Incident Reports: Mixed Methods Analysis of a National Database
A culture of blame and fear of retribution are recognized barriers to reporting patient safety incidents. This article finds a high frequency of blame in a random sample of safety incident reports in the UK, suggesting that there are still opportunities to shift toward a more systems-focused, blame-free culture in health care.
Patient Safety in the Home: Assessment of Issues, Challenges, and Opportunities
This report examines challenges related to patient safety in the home, including fragmentation of care; household hazards; ill-prepared family caregivers; limited training and regulation of home care workers; inadequate communication among patients, caregivers, and providers; and misaligned payment incentives.
Health Care Providers Must Act Now to Address the Prescription Opioid Crisis
While a community-wide approach is also needed to effectively address the opioid crisis, the authors describe some key actions that both providers and organizations can take to begin making a difference, including changing provider prescribing practices.
Does a Quality Improvement Campaign Accelerate Take-up of New Evidence? IHI’s Project JOINTS
IHI’s Project JOINTS initiative engaged a network of state-based organizations and professionals in a six-month QI campaign to promote adherence to three evidence-based practices to reduce surgical site infection (SSI) after joint replacement.
Development of a Trigger Tool to Identify Adverse Events and Harm in Emergency Medical Services
This article describes the development and implementation of the Emergency Medical Services Trigger Tool (EMSTT), a sampling strategy similar to the Global Trigger Tool with EMS-specific triggers, to identify and measure adverse events and harm over time in the Emergency Medical Services setting.
A Framework for Safe, Reliable, and Effective Care
The framework described in this white paper brings together the strategic, clinical, and operational concepts that are critical to creating a "system of safety" that achieves safe, reliable, and effective care.