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Actions to Renew Focus on Safety Culture

Delivering the health care that our patients expect — in every setting and under all conditions — demands that we urgently revisit safety culture as the fundamental driver of both patient and workforce safety.

Organizational Trustworthiness in Health Care

The Institute for Healthcare Improvement partnered with the American Board of Internal Medicine Foundation to identify key organizational-level drivers and change ideas that repair, build, and strengthen trust between health care organizations and clinicians, and between health care organizations and the communities they serve. This report describes a theory of how to repair, build, and strengthen trust, presented as a three-step approach with specific change ideas and associated measures for improvement.

Using Machine Learning to Improve Patient Safety in the Home or Remote Setting for Adults

The primary aim of the IHI innovation project described in this report was to assess the use of predictive analytics, specifically machine learning, to improve patient safety through emerging and existing approaches to predict risk, such as technologies and decision support tools. Specific attention was given to how predictive analytics and machine learning can assist in monitoring patient deterioration in the home setting for adults ages 18 and older.

Avoiding "Drift" into Harm

This article presents specific steps leaders can take to reinforce effective patient safety practices and address workarounds that may unintentionally result in harm.

Preventing Health Care Workforce Suicide

Based on available literature and consensus among leading suicide prevention experts, this article highlights three key areas of mental health that all health care leaders need to prioritize: reduce stigma, increase access to mental health services, and address job-related challenges.

Telemedicine: Ensuring Safe, Equitable, Person-Centered Virtual Care

This white paper describes a framework to guide health care organizations in their efforts to provide safe, equitable, person-centered telemedicine. The framework includes six elements to consider: access, privacy, diagnostic accuracy, communication, psychological and emotional safety, and human factors and system design.

Making Healthcare Safe

Written by Lucian Leape, a pioneer of the patient safety movement, this book describes how patient safety became recognized as an important problem, the underlying science, and the efforts to implement changes.

Prioritizing People and Rapid Learning in Times of Crisis: A Virtual Learning Initiative to Support Health Workers During the COVID‐19 Pandemic

This article reports on an initiative set up within Africa's Western Cape provincial Department of Health early in the COVID-19 pandemic to facilitate collective learning and support for health workers and managers across the health system. Strategies and three transformational actions that protect staff are shared.

How to Safely Restart Elective Surgeries After a COVID Spike

The COVID-19 pandemic has affected surgical schedules and staff: some staff are fatigued and stressed, some may be out of practice, and there are large backlogs of procedures that were postponed. To keep surgical staff and patients safe during these difficult times, this article recommends that health systems should take four steps

A Guide to Promoting Health Care Workforce Well-Being During and After the COVID-19 Pandemic

This guide provides ideas and lessons learned to improve the well-being of the health care workforce and includes actions that individuals, leaders, and organizations can take to combat health care workforce burnout, fatigue, and emotional distress during the COVID-19 pandemic and beyond.

Workforce Safety Key to Patient Safety

Health care leaders increasingly recognize that patient safety is not possible without a workforce that is physically and psychologically safe, joyful, and thriving. This article describes three actionable recommendations to improve workforce safety.

Telemedicine: Center Quality and Safety

This article offers four elements on which health care leaders must focus to ensure safe, high-quality telemedicine for patients.

COVID-19: Patient Safety and Quality Improvement Skills to Deploy During the Surge

The authors suggest a five-step strategy and actions for patient safety and quality improvement staff to employ their skills to support patients, clinical staff, and health care organizations during the COVID-19 pandemic.

Adopting a Systems Approach to the Opioid Crisis

Rather than a myopic focus on opioid prescription reduction, this article describes five strategies health care leaders can employ to implement a systems approach to timely and effective treatment of opioid use disorder, in tandem with pain assessment and management.

Zero Harm in Health Care

This article describes a comprehensive systems-focused approach to patient safety to achieve the goal of zero harm for patients, families, and the health care workforce. The approach includes four interdependent elements: the psychology of change, a culture of safety, an optimal learning system, and codesigning care and improvement with patients.

Advancing Safety and Equity Together

There are widespread inequities in health outcomes in the United States based on race, sex, language, and other factors. But there is no such thing as high-quality, safe care that is inequitable. Health systems can leverage patient-safety programs to advance equity.

The Role of Racism as a Core Patient Safety Issue

Maternal mortality rates in the US are rising, particularly among black women. This article describes three things health care leaders can do to understand the contributing causes of mortality, including racism, and factors to reduce inequities and improve safety in maternal health.

Factors Influencing a Hospital-wide Intervention to Promote Professionalism and Build a Safety Culture

A three-year qualitative study at an Australia hospital identifies valuable insights into factors influencing implementation of a multifaceted behavior change intervention to promote professionalism and build a culture of safety. The multiple interrelated factors impacting the hospital-wide intervention are discussed and analyzed.

Effective Strategies for Hospitals Responding to the Opioid Crisis

This document provides hospital and health system administrators and leaders with specific improvement ideas for five system-level strategies that address the challenges of preventing, identifying, and treating opioid use disorder.

Advancing the Safety of Acute Pain Management

This report specifically and uniquely addresses acute pain management as a patient safety issue, including the overuse of opioids for acute pain. It provides health care safety leaders in hospitals, emergency departments (EDs), urgent care clinics, outpatient surgery facilities, and other acute care settings with specific action steps to improve the safety of acute pain management in their organizations.

Framework for Effective Board Governance of Health System Quality

This white paper presents an actionable framework with the core processes needed for effective board governance of all dimensions of health system quality; an assessment tool; and support guides for three central knowledge areas for trustee oversight of quality.

Effectiveness of a Multistate Quality Improvement Campaign in Reducing Risk of Surgical Site Infections Following Hip and Knee Arthroplasty

This article provides an assessment of IHI’s Project JOINTS initiative, a multistate QI campaign to promote adoption of evidence-based practices to reduce surgical site infections (SSIs) following hip and knee arthroplasty.

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.