Beneath, Beyond Burnout: Solving for Causes.

This article offers a different perspective of the current crisis in health care-burnout that is causing medical errors, disengagement, and economic chaos and forcing talented, experienced health care professionals to leave their institutions or their chosen professions altogether. The lack of meaningful impact lies in the focus on treating problems observed rather than on system issues underlying the more overt symptoms of burnout and attrition. The system within which health care workers perform impacts their capacity to consistently deliver high-quality care.

Using the Targeted Solutions Tool® to Improve Hand Hygiene Compliance Is Associated with Decreased Health Care-Associated Infections.

Background: In 2010 Memorial Hermann Health System (MHHS) implemented the Joint Commission Center for Transforming Healthcare's (the Center's) Web-based Targeted Solutions Tool ®(TST ®) for improving hand hygiene through-out its 12 hospitals after participating in the Center's first project on hand hygiene, pilot testing the TST, and achieving significant improvement for each pilot unit. Because hand hygiene is a key contributing factor in health care-associated infections (HAIs), this project was an important part of MHHS's strategy to eliminate HAIs.

Methods: MHHS implemented the TST for hand hygiene in 150 inpatient units in 12 hospitals and conducted a system wide process improvement project from October 2010 through December 2014.

Memorial Hermann: high reliability from board to bedside.

Background: In 2006 the Memorial Hermann Health System (MHHS), which includes 12 hospitals, began applying principles embraced by high reliability organizations (HROs). Three factors support its HRO journey: (1) aligned organizational structure with transparent management systems and compressed reporting processes; (2) Robust Process Improvement (RPI) with high-reliability interventions; and (3) cultural establishment, sustainment, and evolution.

Methods: The Quality and Safety strategic plan contains three domains, each with a specific set of measures that provide goals for performance: (1) "Clinical Excellence;" (2) "Do No Harm;" and (3) "Saving Lives," as measured by the Serious Safety Event rate.

Proactive error prevention in the intensive care unit.

Care provided in the ICU accounts for nearly 30% of acute care hospital costs and, with the aging of Americans, there is an increased demand for critical care services [1]. Critical illness reduces an individual's physical resilience. Minute-to-minute care decisions and interventions mean life or death during this acute disease phase.