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Transforming concepts in patient safety: a progress report
  1. Tejal K Gandhi1,
  2. Gary S Kaplan2,
  3. Lucian Leape3,
  4. Donald M Berwick1,
  5. Susan Edgman-Levitan4,
  6. Amy Edmondson5,
  7. Gregg S Meyer6,
  8. David Michaels7,
  9. Julianne M Morath8,
  10. Charles Vincent9,
  11. Robert Wachter10
  1. 1 Institute for Healthcare Improvement, Boston, MA, USA
  2. 2 Virginia Mason Health System, Seattle, Washington, USA
  3. 3 Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA
  4. 4 John D Stoeckle Center for Primary Care Innovation, Massachusetts General Hospital, Boston, MA, USA
  5. 5 Harvard Business School, Harvard University, Boston, Massachusetts, USA
  6. 6 Partners Healthcare, Boston, Massachusetts, USA
  7. 7 George Washington University Milken Institute of Public Health, Washington, District of Columbia, USA
  8. 8 California Hospital Quality Institute, Sacramento, California, USA
  9. 9 Experimental Psychology, University of Oxford, London, Oxfordshire, UK
  10. 10 Medicine, University of California San Francisco, San Francisco, California, USA
  1. Correspondence to Dr Tejal K Gandhi, , Institute for Healthcare Improvement, Boston, MA 02109, USA; tgandhi{at}


In 2009, the National Patient Safety Foundation’s Lucian Leape Institute (LLI) published a paper identifying five areas of healthcare that require system-level attention and action to advance patient safety.The authors argued that to truly transform the safety of healthcare, there was a need to address medical education reform; care integration; restoring joy and meaning in work and ensuring the safety of the healthcare workforce; consumer engagement in healthcare and transparency across the continuum of care. In the ensuing years, the LLI convened a series of expert roundtables to address each concept, look at obstacles to implementation, assess potential for improvement, identify potential implementation partners and issue recommendations for action. Reports of these activities were published between 2010 and 2015. While all five areas have seen encouraging developments, multiple challenges remain. In this paper, the current members of the LLI (now based at the Institute for Healthcare Improvement) assess progress made in the USA since 2009 and identify ongoing challenges.

  • patient safety
  • medical education
  • safety culture
  • leadership

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  • Funding This study was funded by Medtronic (grant number #6981).

  • Competing interests None declared.

  • Patient consent Not required.

  • Provenance and peer review Not commissioned; internally peer reviewed.

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