Evidence map›Paper›PMID 16898981›Full record

ArticleHealth services research2006

Creating high reliability in health care organizations.

Peter J Pronovost, Sean M Berenholtz, Christine A Goeschel, Dale M Needham, J Bryan Sexton, David A Thompson, Lisa H Lubomski, Jill A Marsteller, Martin A Makary, Elizabeth Hunt

Abstract read
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In one paragraph

Article in Health services research, 2006. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 103 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
103citing papers in PubMed, 7 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

103 citing papers in PubMed, 7 syntheses or guidelines pooled it.

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43 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors.

Peter J PronovostDepartment of Anesthesiology & Critical Care Medicine, Surgery, and Health Policy & Management, The Johns Hopkins University, 1901 Thames Street, 2nd floor, Baltimore, MD 21231, USA.
Sean M Berenholtz
Christine A Goeschel
Dale M Needham
J Bryan Sexton
David A Thompson
Lisa H Lubomski
Jill A Marsteller
Martin A Makary
Elizabeth Hunt

Funding

Statewide Efforts to Improve Care in Intensive Care UnitUC1HS014246 · AHRQ · JOHNS HOPKINS UNIVERSITY · PI PRONOVOST, PETER J · 2003 to 2004
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AHRQ HHS 1UC1HS14246AHRQ HHS UC1 HS014246
6 · The paper itself

Abstract

objectiveThe objective of this paper was to present a comprehensive approach to help health care organizations reliably deliver effective interventions. CONTEXT: Reliability in healthcare translates into using valid rate-based measures. Yet high reliability organizations have proven that the context in which care is delivered, called organizational culture, also has important influences on patient safety. MODEL FOR IMPROVEMENT: Our model to improve reliability, which also includes interventions to improve culture, focuses on valid rate-based measures. This model includes (1) identifying evidence-based interventions that improve the outcome, (2) selecting interventions with the most impact on outcomes and converting to behaviors, (3) developing measures to evaluate reliability, (4) measuring baseline performance, and (5) ensuring patients receive the evidence-based interventions. The comprehensive unit-based safety program (CUSP) is used to improve culture and guide organizations in learning from mistakes that are important, but cannot be measured as rates.

conclusionsWe present how this model was used in over 100 intensive care units in Michigan to improve culture and eliminate catheter-related blood stream infections--both were accomplished. Our model differs from existing models in that it incorporates efforts to improve a vital component for system redesign--culture, it targets 3 important groups--senior leaders, team leaders, and front line staff, and facilitates change management-engage, educate, execute, and evaluate for planned interventions.

Indexed as

Health FacilitiesHumansIntensive Care UnitsMedical ErrorsMichiganModels, OrganizationalOrganizational CultureQuality Assurance, Health CareSafety Management

Identifiers

PMID16898981
PMCPMC1955341

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.