ROUNDS Preview: The High-Performance Clinical Organization

Jim Molpus, for HealthLeaders Media , April 13, 2012
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This article appears in the April 2012 issue of HealthLeaders magazine.

Editor's note: This piece is an excerpt of a fuller case study that is part of an upcoming Rounds event, Building the High-Performance Clinical Organization. To see the complete case study, which includes three additional lessons and more information, visit

The dozen years now since the Institute of Medicine's highly critical To Err Is Human report have seen incremental yet inconsistent progress in removing the causes of harm that patients encounter in the hospital. Efforts have been often based on short-term annual goals or initiatives that attack narrow areas of patient safety and quality. Henry Ford Health System leadership, starting with the board, decided in 2007 that was not good enough.

The system's "No Harm" campaign did two things: First, it stated that "the highest priority of our quality work is to become a harmless organization." Second, it set a quantitative goal to reduce harm by 50%. From 2008 to 2010, HFHS reduced systemwide harm events by 25%, and extended the program to 2013.

Having a systemwide goal creates a benchmark and an expectation of staff members, says Jennifer Ritz, manager for quality improvement in surgical services and a member of the system's No Harm steering committee. "I can tell you that 50% is a big goal, and there's a lot that goes into that calculation," Ritz says. "But I think what is so unique for us is that we go way beyond those specific metrics that we're measuring for harm reduction. We don't just do the metrics that are in the No Harm campaign. We take it further. Things snowball and we look at projects and we don't just say, ‘Okay, we're going to jump into this initiative because it will help us reduce harm and help us get to that end goal.' We look at prioritization and what is the most urgent area that we need to be focusing on right here and now to reduce the most harm."

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