Transforming concepts in patient safety: a progress report.

In 2009, the National Patient Safety Foundation's Lucian Leape Institute (LLI) published a paper identifying five areas of healthcare that require system-level attention and action to advance patient safety.The authors argued that to truly transform the safety of healthcare, there was a need to address medical education reform; care integration; restoring joy and meaning in work and ensuring the safety of the healthcare workforce; consumer engagement in healthcare and transparency across the continuum of care. In the ensuing years, the LLI convened a series of expert roundtables to address each concept, look at obstacles to implementation, assess potential for improvement, identify potential implementation partners and issue recommendations for action. Reports of these activities were published between 2010 and 2015. While all five areas have seen encouraging developments, multiple challenges remain. In this paper, the current members of the LLI (now based at the Institute for Healthcare Improvement) assess progress made in the USA since 2009 and identify ongoing challenges.

Patient safety: a view from the top.

The view of patient safety from the top encompasses vision, a long-range horizon, and fluency in the current state of system performance. Leadership in patient safety is an active process that demonstrates actions derived from safety as a value. It requires leaders who are accountable, responsible, knowledgeable, vigilant, and directly engaged. Patient safety is not a portfolio of work for leaders to preside over; rather, it is a core strategy of the organization and the health care industry that demands involvement. Patient safety is the work of leaders in this generation of health care: our watch, our time, and our work in achieving the delivery of harm-free care to children.