Quality Improvement
Chairs: Associates in Process Improvement: Lloyd Provost, MS, Clifford L. Norman, MA, Ron Moen, MA, Jerry Langley, MS, Thomas Nolan, PhD, Kevin Nolan, MAIntermountain Health Care: Brent James, MD, MStat
You got into health care because you wanted to help people. But you’re only human. Sometimes you make mistakes — and those mistakes can cause harm.
In fact, if you’re a patient in a hospital, your risk of dying from a medical error is greater than your chance of dying while driving, mountain climbing, or bungee jumping. According to a paper published in JAMA, mistakes kill 180,000 people in the US every year.[1] That’s the equivalent of three jumbo jets crashing every two days.
And then there are other problems that don’t kill people, but still hurt them. Delays. Ineffective treatments. High costs. Lack of respect for patients. Racial and economic inequality.
Clearly, it’s not enough simply to try harder. We need to do things a new way — a better way. Borrowing from the worlds of aviation and manufacturing, great thinkers have developed powerful methods to guide improvement in health care. And an army of people on the front lines — nurses, doctors, pharmacists, and members of other health-related professions — have used those methods to make a difference.
[1] Leape LL. Error in medicine. JAMA. 1994;272:1851-1857.
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Quality Improvement Faculty
Related Courses/Lessons
QI 101: Fundamentals of Improvement
QI 102: The Model for Improvement: Your Engine for Change
QI 103: Measuring for Improvement
You may want to familiarize yourself with the terminology of quality improvement or refer to the quality improvement bibliography to begin your journey.
With a public beset by health care woes — the number of uninsured Americans is rising, primary care doctors are few and far between — a change is coming in US health care policy. But what will that change look like within the next five years? And what will it mean for you as you embark on a career in health care?
In 2006, Massachusetts passed a law requiring almost all adults to have health insurance. Two years later, 439,000 residents are newly insured. But not all the news is good — there’s a shortage of doctors to meet the high demand for primary care services, and some question whether the program is financially sustainable. The nation is watching. What can other states learn from the big experiment in Massachusetts?
Millions of people suffer every year from mistakes in health care. Lucian Leape, MD, explains why those mistakes happen — and how to prevent them.
A doctor winds up in the trauma ICU, where an overheard conversation convinces her she's going to die.
A child is mistakenly vaccinated for hepatitis A, rather than B. Despite forthright disclosure and no evident harm to the child, the father becomes incredibly angry at the providers.
“By and large, hospitals that want to educate health professionals about quality, safety, and teamwork have to start from scratch with each new graduate they hire,” says Linda Cronenwett, PhD, RN, FAAN, Dean and Professor at the University of North Carolina, Chapel Hill School of Nursing (Chapel Hill, North Carolina, USA). She is involved in a national initiative to change that reality.
In 2004 Dr. Brian Koll was searching for a method to speed culture change at his institution, Beth Israel Hospital in New York. This story profiles efforts at the hospital to introduce quality improvement to the next generation of health professionals.
This study interviewed medical students and residents in an academic medical center, and categorized the factors that influenced their learning from errors. The authors concluded that facilities could help by addressing variability in faculty response and by disseminating clear, accessible algorithms to guide behavior when errors occur. The survey also revealed the need for a teaching and learning focus on emotionally charged situations, learning from errors and near misses, and a balance between individual and systems responsibility.
This article describes a study where 77 medical, physician assistant, nurse practitioner, and health services management students were provided training in quality improvement, community-oriented primary care, and teamwork. These students were then formed into 13 interdisciplinary teams to apply their knowledge in underserved areas ("service learning") under a community and faculty preceptor.
