Applying international organization for standards 9001 to create an effective surgical quality committee.

BACKGROUND: Efforts to improve surgical safety are limited by several factors and no consensus exists regarding the most effective way to improve surgical quality. The use of ISO 9001 quality standards within healthcare is recognized but has not been widely applied for improving surgical outcomes. METHODS: A surgical quality committee was created using ISO 9001:2015 standards. Quality objectives were assessed to understand how any suggested changes will be impacted due to risks and opportunities inherent in the system. RESULTS: The initial quality focus was on surgical site infections in 5 services. Change in surgical infection ratio from 2018 to 2019 showed significant improvement: coronary bypass 1.288 vs. 0.901; Colon 1.359 vs. 0.589; Hysterectomy 2.119 vs. 1.022; Knee 1.391 vs. 0.306; Hip 0 vs. 0.302. CONCLUSIONS: This is one of the first studies using ISO 9001 to improve surgical quality. The results indicate both acceptance and success of applying continual improvement strategies.

Advocate health care: a systemwide approach to quality and safety.

BACKGROUND: Advocate Health Care's culture of safety is rooted in its mission, values, and philosophy and demonstrates a profound regard for the welfare of those it serves. Its five values--excellence, compassion, partnership, equality, and stewardship--provide the foundation for interactions with patients. PATIENT SAFETY AS A LEADERSHIP AND ORGANIZATIONAL PRIORITY: Patient safety has been a leadership and organizational priority since 1999, when the chief executive officer and chief medical officer appointed an eight-member patient safety task force. The treatment of patient safety as a priority is reflected, for example, in sustained support for the patient safety task force's four teams (labor and delivery, nosocomial infection prevention, medication error prevention, and delayed/missed diagnoses), in the allocation of significant financial resources to technology, and in the dedication of additional capital to create safer physical-facility designs. CHALLENGES AND LESSONS LEARNED: To implement and sustain a culture of safety, Advocate addressed three challenges: complexity of the system, underreporting of patient safety events, and medical staffs acceptance of the disclosure policy. For example, strategies to address the underreporting challenge include creating a standardized patient safety event form, integrating disparate databases for patient safety event reporting, and providing ongoing education to reinforce the need to report events. Advocate's most significant area for improvement is to become less reliant on risk reduction strategies that may result only in short-term improvements.