Improving the Reliability of Health Care

How to cite this paper:

Nolan T, Resar R, Haraden C, Griffin FA. Improving the Reliability of Health Care. IHI Innovation Series white paper. Boston: Institute for Healthcare Improvement; 2004. (Available on

IHI’s Innovation Series white papers were developed to further our mission of improving the quality and value of health care. The findings and tools in these reports provide you with an opportunity to understand and evaluate the issues, and begin testing changes that can help your organization make breakthrough improvements.
Reliability principles — methods of evaluating, calculating, and improving the overall reliability of a complex system — have been used effectively in industries such as manufacturing to improve both safety and the rate at which a system consistently produces appropriate outcomes.
The Institute for Healthcare Improvement (IHI) believes that applying reliability principles to health care has the potential to help reduce “defects” in care or care processes, increase the consistency with which appropriate care is delivered, and improve patient outcomes.
IHI is working with a group of hospitals to apply reliability principles to care processes. These hospitals are using a three-step model for applying principles of reliability to health care systems:
  1. Prevent failure (a breakdown in operations or functions).
  2. Identify and Mitigate failure
  3. Redesign the process based on the critical failures identified.
This IHI white paper offers specific strategies for each step in the model, as well as a template based on this model for increasing reliability of care for heart failure (HF) patients.
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