Here is a link to an eBook I just edited. I also wrote the chapter: System Safety in the NICU. This book captures the work of the Vermont Oxford Network's NICQ project.

 

Just published in Clinics in Perinatology

Abstract:

Human factors analysis (HFE) presents a formidable contribution to quality improvement (QI) in the neonatal intensive care unit (NICU). The science behind the fundamental principles concerning the design of work systems that match the needs of the people who work in them is sound and is applied widely in other safety critical situations. Early application of HFE in NICUs has shown the usefulness of these methods for frontline teams working to improve quality, reliability, and safety. The inclusion of human factors considerations in the design of structure and process has the potential to improve outcomes for patients and families and to improve the comfort and usability of work systems for providers who work in them. New technologies and continual change must be informed and designed through the application of HFE methods and principles to realize the full potential of QI.

In Switch, the authors present examples of successful big changes - like improving child nutrition in impoverished Vietnam or reducing nurse turnover but they also implore the reader to apply the same principles to their own personal, n-of-1 improvement. Improvement is a such a common human aspiration it's fitting that fundamental principles have universal application from a personal to a global scale.

In a recent article about safety and quality improvement education in medical school the authors point to a successful strategy they've used for several years. Students are given an assignment to carry out a personal improvement project that includes areas such as exercise, diet, or study habits. "Students use process diagrams, fishbone diagrams, and run and control charts; carry out PDSA cycles; and make daily measurements (miles run, colas drunk, or minutes of study) so they can link their process to outcomes." They even have a personal improvement workbook freely available. (download here)

Those of us keen on sharpening our improvement habits can do so by turning the improvement process in on ourselves. If you can internalize sound improvement method in your own changes it may bring added resolve and discipline to your NICU team's quality improvement work.

A different twist to the words of Mahatma Gandhi... "Be the change you want to see in the world."