• Compliance rates with patient safety goals
• Rate of improvement over time
• Ability to maintain gains

Changes

• Standardize locations of mechanical ventilators to ensure adequate supplies and save space.
• Simplify and standardize routine anesthesia set-up using a shadow board.
• Use redundancy, self-checks, and successive checks to assure Ventilator Bundle implementation to reduce ventilator-associated pneumonia (VAP).
• Develop and implement a checklist and apply “stop-the-line” to assure Central Line Bundle use.
• Use simple visual controls to reduce intensive insulin infusion associated with hypoglycemia.
• Hold weekly, local leader safety rounds as a successive check  to assess staff/system performance with key safety initiatives and seek further opportunities for improvement.

• Encouraging innovation and participation in patient safety and process improvement work has changed our culture.
• Maintaining the gains, spreading successful work, and improving reliability are done by local leaders using direct observation and team building activities.
• Make processes simple, part of daily work, and value-added for the patient leads to success.
• Standardized work processes enable new staff to join the workforce faster, and provide incentives to long-term staff (extra time, ease of mind).