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  • SBAR: Situation-Background-Assessment-Recommendation
    for Improvement forming the improvement team setting aims establishing measures and selecting and testing changes Go to How to Improve IHI LR Wide SBAR Situation Background Assessment Recommendation Page Content The SBAR Situation Background Assessment Recommendation technique created by clinical staff at Kaiser Permanente in Colorado provides a framework for communication between members of the health care team about a patient s condition SBAR is an easy to remember concrete mechanism useful for framing any conversation especially critical ones requiring a clinician s immediate attention and action It allows for an easy and focused way to set expectations for what will be communicated and how between members of the team which is essential for developing teamwork and fostering a culture of patient safety Recommended Resources first last Develop a Culture of Safety In a culture of safety people are not merely encouraged to work toward change they take action when it is needed SBAR Technique for Communication A Situational Briefing Model The SBAR Situation Background Assessment Recommendation technique provides a framework for communication between members of the health care team and can be used as a tool to foster a culture of patient safety Tools Loading Pages first last Rapid Response Team Record Documentation Tool This tool is used to document each response to a Rapid Response Team call and the embedded SBAR Situation Background Assessment Recommendation section is helpful for framing the conversation with the team or the provider Sample Rapid Response Team Documentation Tool This tool is used to document each response to a Rapid Response Team call and the embedded SBAR Situation Background Assessment Recommendation section is helpful for framing the conversation with the team or the provider physician Rapid Response Team Record with SBAR Both the primary nurse for the patient and the Rapid Response Team nurse have responsibility for completing the form when a Rapid Response Team call is initiated and the form then becomes a permanent part of the patient SBAR Training Scenarios and Competency Assessment Bronson Healthcare Group Kalamazoo Michigan USA SBAR Toolkit This toolkit contains multiple SBAR Situation Background Assessment Recommendation tools that clinical teams can use to standardize communication about important information View All Audio Content Loading Pages first last WIHI SBAR Structured Communication and Psychological Safety in Health Care January 30 2014 This WIHI looks at how the communication tool known as SBAR Situation Background Assessment Recommendation can be used for improved handoffs or to enhance newer processes such as daily safety huddles to achieve psychological safety among all staff Profiles in Improvement Doug Bonacum of Kaiser Permanente Who s improving health care People are Listen to the story of Doug Bonacum of Kaiser Permanente View All More on This Topic Loading Pages first last WIHI SBAR Structured Communication and Psychological Safety in Health Care January 30 2014 This WIHI looks at how the communication tool known as SBAR Situation Background Assessment Recommendation can be used for improved handoffs or to enhance newer processes such as daily safety huddles to

    Original URL path: http://www.ihi.org/Topics/SBARCommunicationTechnique/Pages/default.aspx (2016-02-01)
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  • Trigger Tools
    established that only 10 to 20 percent of errors are ever reported and of those 90 to 95 percent cause no harm to patients Hospitals need a more effective way to identify events that do cause harm to patients in order to select and test changes to reduce harm Trigger Tools provide an easy to use method for accurately identifying AEs harm and measuring the rate of AEs over time Tracking AEs over time is a useful way to tell if changes being made are improving the safety of the care processes Start here Introduction to Trigger Tools for Measuring Adverse Events Recommended Resources first last IHI Global Trigger Tool for Measuring Adverse Events Second Edition This white paper provides information on the development and methodology of the IHI Global Trigger Tool enabling the ability to accurately identify adverse events and measure the rate of adverse events over time IHI Trigger Tool for Measuring Adverse Drug Events A method for using triggers or clues in patient records to identify ADEs that may not have been reported through traditional mechanisms Training Record Set for IHI Global Trigger Tool Use this Training Record Set to train new reviewers how to use the IHI Global Trigger Tool for Measuring Adverse Events Tools Loading Pages first last Global Trigger Tool Implementation Toolkit This compendium of resources was developed by Florida Hospital Orlando Florida USA or adapted from the Institute for Healthcare Improvement IHI in the hospital s implementation of the IHI Global Trigger Tool IHI Global Trigger Tool for Measuring Adverse Events The use of triggers or clues to identify adverse events AEs is an effective method for measuring the overall level of harm in a health care organization IHI Global Trigger Tool Training Resources A suggested plan and materials to help train reviewers on the IHI Global Trigger Tool methodology IHI Intensive Care Unit ICU Adverse Event Trigger Tool The ICU Adverse Event Trigger Tool provides instructions for conducting a retrospective review of patient records using triggers to identify possible adverse events IHI Outpatient Adverse Event Trigger Tool This tool is used to identify outpatient related adverse events using specifically defined triggers or clues View All Audio Content Loading Pages first last WIHI The Power to Detect and Improve Revisiting the IHI Global Trigger Tool and Adverse Events April 14 2011 The authors discuss a new study in Health Affairs that finds that the IHI Global Trigger Tool identified at least ten times more confirmed serious events than other methods WIHI The Power to Detect and Reduce Harm IHI s Global Trigger Tool and Adverse Events in the US October 21 2010 This WIHI provides a window into research findings from a series of reports from the Office of Inspector General and their significance for patient safety harm detection improvement work and policy reform going forward The IHI Global Trigger Tool for identifying adverse events is also a focus of the discussion View All Video Content Loading Pages first last Passport Exclusive Improvement

    Original URL path: http://www.ihi.org/Topics/TriggerTools/Pages/default.aspx (2016-02-01)
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  • IHI Skilled Nursing Facility Trigger Tool for Measuring Adverse Events
    of inpatient hospital records using triggers or clues to identify possible adverse events Identifying adverse events and the types of harm resulting from such adverse events can lead to opportunities to improve patient and resident safety Tracking the rate of adverse events over time is a useful way to tell if changes being made are improving the safety of care processes The IHI Skilled Nursing Facility Trigger Tool for Measuring Adverse Events provides Step by step instructions for using this methodology to identify adverse events in SNFs and determine the level of harm associated with such events Detailed guidance on designing a Trigger Tool review A list of SNF specific triggers and definitions Examples of adverse events that occur in SNFs An extensive Frequently Asked Questions section Documents Documents IHI Skilled Nursing Facility Trigger Tool for Measuring Adverse Events Average Content Rating 1 user Your comments were submitted successfully Please enter a comment Please login to rate or comment on this content User Comments by mona mohammad 12 8 2015 1 43 34 PM an excellent site provide an valued ideas and comprehensive information loading Did you find this user comment useful people found this user comment useful Report This Show More Comments Loading You are about to report a violation of our Terms of Use All reports are strictly confidential Reason Select One Contains profanity or violence Spam Defamatory Illegal Unlawful Copyright Violation Other Please select a reason for this report Add a Note Your comments were submitted successfully There was an error reporting your complaint More on This Topic Loading Pages first last WIHI New Tools and Thinking for Shared Decision Making January 28 2016 If you work in primary care today odds are good that you re seeing patients with multiple chronic conditions Even if a provider and patient work together to choose the right medications and agree on making some lifestyle changes that will improve health the best laid plans often fall apart WIHI Harnessing Improvement to Reduce Diagnostic Errors and Delays December 1 2015 One in twenty adults suffers a diagnostic error every year How do we take such a formidable analysis and wake up call about patient safety and turn it into opportunity Profiles in Improvement Azhar Ali IHI Executive Director Middle East and Asia Pacific In this profile IHI Executive Director Azhar Ali talks about the path that led him to IHI and the growing portfolio of IHI s work in the Middle East and Asia Pacific regions that he is overseeing and helping to build Profiles in Improvement Jennifer Lenoci Edwards RN MPH IHI Director Patient Safety In this profile Jennifer Lenoci Edwards IHI Director of Patient Safety talks about the experiences that shaped her passion and dedication to improving safety and the current focus of IHI s work in patient safety which includes safety across the continuum of care engaging patients in safety efforts and supporting health care teams in improving system reliability and enhancing their joy in work Rethinking Critical

    Original URL path: http://www.ihi.org/resources/Pages/Tools/SkilledNursingFacilityTriggerTool.aspx (2016-02-01)
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  • Changing Culture, Changing Care: Reducing Elective C-Sections in Brazil
    because of misbehavior and for not following the new standards It was painful We had to have very strong leadership The nurses on the contrary were early adopters They embraced the changes and supported the project team and the leadership They were essential for the change IHI Was there an effort to engage mothers in this initiative How was the effort perceived by women and their families and did that perception change over time PB Another important driver for the changes we implemented was family engagement We redesigned the educational course to prepare the mother and family for a natural birth We explained that the new care model focuses on safety and quality However we made a point to highlight that the obstetrician providing prenatal care would not necessarily be the one assisting in the birth Pregnant women and their families did not buy into the idea right away It was difficult for them to understand this new rule At first they did not accept it especially those mothers who were close to their due date It took nine months for us to notice a major cultural change Women who became pregnant after the transition to the new care model were more willing to accept the changes When we reached 71 percent of women delivering by natural birth in Jaboticabal São Paulo the whole city was talking about it There was still a lot of misunderstanding about our intentions People started posting on social media accusing us of not performing C sections at all and forcing pregnant women to have a vaginal delivery It sounds crazy that people would ask for a C section even when it was not for a medical reason This distortion was the result of a 20 year old C section culture strongly reinforced by the health care system Unfortunately as a result of this negative reaction on social media and in the press the vaginal delivery rate went back down to 20 percent The solution was to join with others to support the changes and to raise both public and professional awareness about why we were implementing the new care model We held a public meeting in conjunction with the Municipal Secretary of Health the regulatory agency non governmental organizations that support natural birth in Brazil the Ministry of Health and the Brazilian Society of Obstetricians and Gynecologists The public meeting had large participation from the whole community and was a big hit After this event the community was more informed and started to support the initiative The natural birth delivery rate went back up to around 50 percent IHI What surprised you PB I was surprised about how misinformed the families pregnant women and the community are about birth Some obstetricians behavior also shocked us There is no evidence for elective C sections but they still resisted In addition what is worse they were professedly against the changes instigating the families and pregnant women to fight back and restore the old model of care

    Original URL path: http://www.ihi.org/communities/blogs/_layouts/ihi/community/blog/itemview.aspx?List=7d1126ec-8f63-4a3b-9926-c44ea3036813&ID=179 (2016-02-01)
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  • IHI Global Trigger Tool for Measuring Adverse Events (Second Edition)
    hospital The Institute for Healthcare Improvement IHI formed the Idealized Design of the Medication System IDMS Group in May 2000 The group of 30 physicians pharmacists nurses statisticians and other professionals established an aim to design a medication system that is safer by a factor of 10 and more cost effective than systems currently in use The Trigger Tool for Measuring Adverse Drug Events was initially developed by this group and provided the basis for development of subsequent Trigger Tools This white paper provides comprehensive information on the development and methodology of the IHI Global Trigger Tool with step by step instructions for using the tool to accurately identify adverse events harm and measure the rate of adverse events over time Documents Documents IHI Global Trigger Tool Average Content Rating 2 users Your comments were submitted successfully Please enter a comment Please login to rate or comment on this content User Comments by Silvia Espinosa 9 5 2014 7 09 15 PM I really like this tool to identify problems not reported loading Did you find this user comment useful people found this user comment useful Report This by sherrie fritz 7 5 2014 11 19 42 PM Found this very usefully information NAU student studying Medical staff services AA degree loading Did you find this user comment useful people found this user comment useful Report This by Sheila Fair 1 30 2014 4 04 48 PM White Paper HI Global Trigger Tool for Measuring Adverse Events Second Edition Sheila Fair Instructor sherry Grover January 30 2014 This article mentions the Traditional efforts to detect adverse events have focused on voluntary reporting and tracking of errors The answer was thought to be switching to Electronically Medical Records changing the system thus software programs all over the United States Hospitals Medical Offices and or Private Practices were set forth to change per Obama instructions to do so This would mean they would have to purchase this special medical software program thus pay to train an employee who would train all other staff members to successfully use and maneuver within this program of choice This specific program was very costly for the health care systems One major feature for this program was to reduce as well as to track medical errors I guess my quandary thus is the article refers to a more extensive way of tracking such loading Did you find this user comment useful people found this user comment useful Report This by Maria Cecilia Morales 11 3 2013 5 14 19 PM Excellent Useful Read it loading Did you find this user comment useful people found this user comment useful Report This by Kamal Uddin Siddiqui 8 21 2013 9 48 57 AM Excellent loading Did you find this user comment useful people found this user comment useful Report This by LEELA BABY 1 14 2013 10 53 14 AM Very useful loading Did you find this user comment useful people found this user comment useful Report This by

    Original URL path: http://www.ihi.org/resources/Pages/IHIWhitePapers/IHIGlobalTriggerToolWhitePaper.aspx (2016-02-01)
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  • Leadership Guide to Patient Safety
    Four Establish Oversee and Communicate System Level Aims Step Five Track Measure Performance Over Time Strengthen Analysis Step Six Support Staff and Patients Families Impacted by Medical Errors Step Seven Align System Wide Activities and Incentives Step Eight Redesign Systems and Improve Reliability The concepts are based on the experience the Institute for Healthcare Improvement has gained through years of guiding organizations in improving patient safety Although the focus of this paper is on the acute care setting most of the concepts apply to other settings of care as well It is understood that organizations will be at different stages of development and thus will move at different paces through the improvement process An organization with significant experience in improvement methodology and a successful portfolio of previous safety work will be able to make progress at a faster pace than an organization that has yet to build the infrastructure and commitment to safety at all levels Documents Documents IHI Leadership Guide to Patient Safety White Paper Average Content Rating 4 users Your comments were submitted successfully Please enter a comment Please login to rate or comment on this content User Comments by Jan Ozga 12 24 2014 1 07 34 PM Is there an updated version of ihi s leadership guide to patient safety which is dated 2006 loading Did you find this user comment useful people found this user comment useful Report This by siu yuen fai 10 13 2014 11 56 11 AM hope to through the learning materials achieve goal for improving patient safety loading Did you find this user comment useful people found this user comment useful Report This by Grace Lin 2 14 2014 7 26 42 PM good strategies loading Did you find this user comment useful people found this user comment useful Report This by Ebtissam Tag Eldin 6 26 2013 7 29 57 AM very useful to get leadr commited involved to quality loading Did you find this user comment useful people found this user comment useful Report This by Eman Mattar 3 7 2013 11 49 13 AM it is very good source for new leaders or nurse mangers to have ideas for promoting patient safety in health care units loading Did you find this user comment useful people found this user comment useful Report This by Linda Stevens 10 21 2012 9 01 52 PM Excellent a must read to get an understanding of leadership s role related to patient safety culture plans and actions to improve care from the top down in an organization loading Did you find this user comment useful people found this user comment useful Report This Show More Comments Loading You are about to report a violation of our Terms of Use All reports are strictly confidential Reason Select One Contains profanity or violence Spam Defamatory Illegal Unlawful Copyright Violation Other Please select a reason for this report Add a Note Your comments were submitted successfully There was an error reporting your complaint More on

    Original URL path: http://www.ihi.org/resources/Pages/IHIWhitePapers/LeadershipGuidetoPatientSafetyWhitePaper.aspx (2016-02-01)
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  • SBAR Technique for Communication: A Situational Briefing Model
    Human factors and surgical outcomes A Cartesian dream Lancet 1997 349 9053 723 725 de Leval MR Carthey J Wright DJ Farewell VT Reason JT Human factors and cardiac surgery A multicenter study Journal of Thoracic and Cardiovascular Surgery 2000 119 4 Pt 1 661 672 Frank JR Langer B Collaboration communication management and advocacy Teaching surgeons new skills through the CanMEDS Project World Journal of Surgery 2003 27 8 972 978 Helmreich RL Merritt AC Culture at Work in Aviation and Medicine National Organizational and Professional Influences Aldershot Great Britain Ashgate 2001 Helmreich RL On error management Lessons from aviation British Medical Journal 2000 320 7237 781 785 Kosnik LK The new paradigm of crew resource management Just what is needed to re engage the stalled collaborative movement Joint Commission Journal on Quality Improvement 2002 28 5 235 241 Sherwood G Thomas E Bennett DS Lewis P A teamwork model to promote patient safety in critical care Critical Care Nursing Clinics of North America 2002 14 4 333 340 Young GJ Charns MP Daley J Forbes MG Henderson W Khuri SF Best practices for managing surgical services The role of coordination Health Care Management Review 1997 22 4 72 81 Documents Documents SBAR Guidelines SBAR Worksheet Average Content Rating 8 users Your comments were submitted successfully Please enter a comment Please login to rate or comment on this content User Comments by Linda Rosemeyer 11 15 2015 6 44 42 PM Thank you for the informative tools loading Did you find this user comment useful people found this user comment useful Report This by Diane Bonet 11 3 2015 2 02 57 PM I have a question Does using the SBAR tool eliminate the use of giving verbal report when transferring a patient from one inpatient unit to another For example if the emergency room is admitting a patient to a particular unit should verbal report be given in addition to viewing the SBAR loading Did you find this user comment useful people found this user comment useful Report This by Verne LaGrega 9 21 2015 2 54 38 PM thanks so much for the useful tools loading Did you find this user comment useful people found this user comment useful Report This by L B 7 11 2015 10 30 29 AM Am very thankful to learn of this tool before sitting for NCLEX TY loading Did you find this user comment useful people found this user comment useful Report This by Vik Kalke 3 31 2015 10 08 19 PM I have worked in a tertiary hospital as a Lead Project officer implementing the SBAR technique for Medical Clinical Handover and some of the tips are Establish a Steering Committee consisting of representations from all levels Unit directors Consultants PHO JHO and interns Dedicate a person team to educate of the use of SBAR to staff Ensure the change permeates through the higher level by attending departmental meetings and promoting it by presentations and helping staff to

    Original URL path: http://www.ihi.org/resources/Pages/Tools/SBARTechniqueforCommunicationASituationalBriefingModel.aspx (2016-02-01)
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  • Overview
    demographics and other pressures facing health care delivery systems combine to make this a major issue Organizations need to move from multiple disjointed initiatives focused on marginal cost reductions towards integrated strategies that improve outcomes by securing value from every dollar spent IHI is responding to that requirement looking into new tools and methods that can help clinicians and patients build equitable and sustainable solutions IHI is developing innovative approaches to help organizations transition from high volume care to high value care and shift the balance of care from the hospital to the community IHI s focus on quality cost and value includes Creating or designing and applying a diagnostic assessment methodology that will help organizations understand their most productive opportunities plan for higher value and drive cost optimization through quality improvement with measures and metrics Identifying diverse health care systems aiming to remove waste harm and variation and working with them to prioritize the most impactful interventions and methods with a view to scaling up and spreading those approaches and Designing testing and spreading methods to improve quality and reduce costs for people with chronic conditions including risk prediction preventive care and reducing readmissions Upcoming Programs first last Improving Care Transitions to Reduce Readmissions Begins February 4 2016 IHI Expedition Health systems working on the Triple Aim must work across settings because poorly organized care is potentially harmful to patients frustrating for providers and leads to hospital penalties Poor care coordination can deter ACO or bundled payment efforts Join our web based IHI Expedition Improving Care Transitions to Reduce Readmissions Over the course of five sessions faculty will teach participants to reassess how they handle all hospitalizations not just readmissions 17th Annual Summit on Improving Patient Care in the Office Practice and the Community March 20 22 2016 Orlando

    Original URL path: http://www.ihi.org/Topics/QualityCostValue/Pages/Overview.aspx (2016-02-01)
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