Why Does it Matter?

Module 1:

• Kohn, L.T., Corrigan, J.M., Donaldson, M.S., et al. (2000) To Err is Human. National Academy of Sciences.
• Medical Professionalism Project: ABIM Foundation. (2002) Medical Professionalism in the New Millennium: A Physician Charter. Annals of Internal Medicine.
• American Society of Anesthesiologists. (2008) Guidelines for the Ethical Practice of Anesthesiology.
• Drolet B.C, Lorenzi N.M. (2011) Translational Research. Translational Research:Understanding the Continuum from Bench to Bedside. Volume 157, Number 1.
• Institute of Medicine. (2001) Crossing the Quality Chasm: A New Health System for the 21st Century
• James J.T. (2013) A New, Evidence-based Estimate of Patient Harms Associated with Hospital Care. Journal of Patient Safety, Volume 9, Number 3.
• Makary, M.A., Daniel M. (2016) Medical Error- the Third Leading Cause of Death in the US. The BMJ, BMJ 2016;353:i2139 doi: 10.1136/bmj.i2139.
• Nanji K.C., Patel A., Shaikh S., Seger D.L., Bates D.W. (2016) Evaluation of Perioperative Medication Errors and Adverse Drug Events. This Month in Anesthesiology, page 1A.

What’s the Problem?

Module 2:

• Brown, C. (2008) An Epistemology of Patient Safety Research: A Framework for Study Design and Interpretation. Part 1. Conceptualizing and Developing Interventions. BMJ Quality & Safety, Volume 17, pages 158-162.
• Brown, C. et al. (2008) An Epistemology of Patient Safety Research: A Framework for Study Design and Interpretation. Part 2. Study Design. BMJ Quality & Safety, Volume 17, pages 163–169.

What’s the Plan?

Module 3:

There are no additional module 3 resources.

How Do We Make it Happen?

Module 4:

• Wick E.C., Galante D.J., Hobson D.B., Benson A.R., Lee K.H., Berenholtz S.M., Efron J.E., Pronovost P.J., Wu C.L. (2015) Organizational Culture Changes Result in Improvement in Patient-Centered Outcomes. Journal of the American College of Surgeons, Vol. 221, No. 3.
• Bandari, J., Schumacher, K., Simon, M., Cameron, D., Goeschel, C.A., Holzmueller, C.G., Makary, M.A., Welsh, R.J., Berenholtz, S.M (2012) Surfacing Safety Hazards Using Standardized Operating Room Briefings and Debriefings at a Large Regional Medical Center. The Joint Commission Journal on Quality and Patient Safety, Volume 38, Number 4.
• Benn, J., Arnold, G., Wei, I., Riley, C. Aleva, F. (2012) Using Quality Indicators in Anaesthesia: Feeding Back Data to Improve Care. British Journal of Anaesthesia, doi:10.1093/bja/aes173.
• Miller, F.J., Emmanuel, E.J. (2008) Quality-Improvement Research and Informed Consent. The New England Journal of Medicine, Volume 358, Number 8.
• Niemann, C.U., Feiner, J. (2010) Quality Improvement in Transplant Anesthesia: Which Way Forward? DOI:10.1097/MOT.0b013e3283397413.
• Perla, R.J., Provost, L.P., Murray, S.K. (2011) The Run Chart: A Simple Analytical Tool for Learning from Variation in Healthcare Processes. BMJ Quality & Safety, doi:10.1136/bmjqs.2009.037895.
• Peterson, S., Taylor, R., Sawyer, M., Nagy, P., Paine, L., Berenholtz, S., Miller, R., Petty, B., (2015) The Power of Involving House Staff in Quality Improvement: An Interdisciplinary House Staff–Driven Vaccination Initiative. American Journal of Medical Quality, Vol. 30, Number 4, pages 323–327.
• Portela, M.C., Pronovost, P.J., Woodcock, T., Carter, P., Dixon-Woods, M. (2015) How to Study Improvement Interventions: A Brief Overview of Possible Study Types. BMJ Quality & Safety, doi:10.1136/bmjqs-2014-003620.
• Pronovost, P.J., Demski, R., Callender, T., Winner, L., Miller, M.R., Austin, J.M., Berenholtz, S.M. (2013) Demonstrating High Reliability on Accountability Measures at The Johns Hopkins Hospital. The Joint Commission Journal on Quality and Patient Safety, Volume 39, Number 12.
• Shekelle, P.G., Pronovost, P.J., Wachter, R.M. (2013) The Top Patient Safety Strategies That Can Be Encouraged for Adoption Now. Annals of Internal Medicine, Volume 158, Number 5 (Part 2).
• Varkey, P., Antonio, K. (2010) Change Management for Effective Quality Improvement: A Primer. American Journal of Medical Quality, Volume 25, Number 4, pages 268–273.
• Wick, E.C., Hobson, D.B., Bennett, J.L., Demski, R., Maragakis, L., Gearhart, S.L., Efron, J., Berenholtz, S.M., Makary, M.A. (2012) Implementation of a Surgical Comprehensive
  Unit-Based Safety Program to Reduce Surgical Site Infections. American College of Surgeons, http://dx.doi.org/10.1016/j.jamcollsurg.2012.03.017.

How Do We Know it Worked?

Module 5:

• Brown, et al. (2008) An Epistemology of Patient Safety Research: A Framework for Study Design and Interpretation. Part 3. End Points and Measurement. BMJ Quality & Safety, doi:10.1136/qshc.2007.023655.
• Brown, et al. (2008) An Epistemology of Patient Safety Research: A Framework for Study Design and Interpretation. Part 4. One Size Does Not Fit All. BMJ Quality & Safety, doi:10.1136/qshc.2007.023663.
• Weiss, C.H., (1997) Methods for Assessing Program Effectiveness. Columbia University.