Changes for Improvement

While all changes do not lead to improvement, all improvement requires change. The ability to develop, test, and implement changes is essential for any individual, group, or organization that wants to continuously improve.
 
Selecting, testing, and implementing changes is a core element of the Model for Improvement, a simple yet powerful tool for accelerating improvement that has Model for Improvementbeen widely used by the Institute for Healthcare Improvement and hundreds of health care organizations in many countries to improve numerous health care processes and outcomes.
 
After generating ideas for changes your team might try, use rapid Plan-Do-Study-Act (PDSA) cycles to test a change or group of changes on a small scale to see if they result in improvement. If they do, expand the tests and gradually incorporate larger and larger samples until you are confident that the changes should be adopted more widely.
 
Of course, measurement is a key component of testing and implementing changes. Establishing key measures will help your team determine if the changes you are implementing are leading to improvement.
 

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  • Appoint a Safety Champion for Every Unit
    Communicating information about patient safety is an important responsibility that should not always fall to managers alone.
  • Conduct Patient Safety Leadership WalkRounds™
    Senior leaders wishing to demonstrate their commitment to safety and learn about the safety issues in their own organization can do so by making regular rounds for the sole purpose of discussing safety with the staff.
  • Conduct Safety Briefings
    Safety briefings in patient care units are tools to increase safety awareness among front-line staff and foster a culture of safety.
  • Create a Reporting System
    In a culture of safety, staff members are aware of safety issues and are free to report conditions that could lead to near misses or actual adverse events.
  • Create an Adverse Event Response Team
    After any adverse event, members of the response team take prompt action.
  • Designate a Patient Safety Officer
    True commitment to patient safety requires action, not just statements about its importance.
  • Develop a Culture of Safety
    In a culture of safety, people are not merely encouraged to work toward change; they take action when it is needed.
  • Involve Patients in Safety Initiatives
    Patients and their families can provide another layer of defense against adverse events, and in fact they are often the best sources of information.
  • Provide Feedback to Front-Line Staff
    Feedback to the front-line staff is a critical component of demonstrating a commitment to safety and ensuring that staff members continue to report safety issues.
  • Reenact Real Adverse Events from Your Hospital
    With staff members as actors, a simple skit or videotape of a reenacted adverse event or near-miss can raise safety awareness and teach both staff and management valuable safety lessons.
  • Relay Safety Reports at Shift Changes
    Certain situations increase the risk of adverse events and should prompt staff to be even more safety-conscious than usual.
  • Simulate Possible Adverse Events
    Many other industries, particularly aviation, use simulation to teach people to recognize problems and understand the effects of their responses in a safe environment.

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  • What Is a Bundle?
    IHI Vice President and patient safety expert, Carol Haraden, PhD, clarifies what a "bundle" is and is not, and suggests tips for using bundles most effectively to get results in improvement initiatives. While the allure of this tool is undeniable, says Haraden, quality teams should resist the impulse to label any list of good changes a bundle.