First, Do No Harm: Creating a Culture and Systems for Safety at Cleveland Clinic London

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Patient safety is an area of key focus in healthcare improvement efforts, as it is widely recognized that safety failings resulting in patient harm are frequent occurrences in United States and global health care. Safety science research arising from health care and other industries has identified a number of elements that foster safety. Reason’s safety culture model, Donabedian’s quality model, and high reliability organizing are among these. In addition, the reporting and investigation of, and learning from, lapses in patient safety are commonly used tools for safety improvement. The goal of this project is the creation of a culture and systems to support patient safety in a newly built hospital and outpatient facility in London. The de novo building of a culture that supports safety, accompanied by the implementation of systems of reporting and measurement, are the key interventions. The results include objective data indicating a strong culture of safety, the successful registration of the hospital by the United Kingdom regulator, high rates of safety event reporting, and strong measures of safe outcomes during early operations. These results support the effectiveness of the approach taken to design and implement safe systems of care at Cleveland Clinic London.



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