Standardization in patient safety: the WHO High 5s project.
OBJECTIVE
Despite its success in other industries, process standardization in health care has been slow to gain traction or to demonstrate a positive impact on the safety of care.


METHODS
The High 5s project is a global patient safety initiative of the World Health Organization (WHO) to facilitate the development, implementation and evaluation of Standard Operating Protocols (SOPs) within a global learning community to achieve measurable, significant and sustainable reductions in challenging patient safety problems.


OBJECTIVE
The project seeks to answer two questions: (i) Is it feasible to implement standardized health care processes in individual hospitals, among multiple hospitals within individual countries and across country boundaries? (ii) If so, what is the impact of standardization on the safety problems that the project is targeting?


METHODS
The two key areas in which the High 5s project is innovative are its use of process standardization both in hospitals within a country and in multiple participating countries, and its carefully designed multi-pronged approach to evaluation.
Three SOPs-correct surgery, medication reconciliation, concentrated injectable medicines-have been developed and are being implemented and evaluated in multiple hospitals in seven participating countries. Nearly 5 years into the implementation, it is clear that this is just the beginning of what can be seen as an exercise in behavior management, asking whether health care workers can adapt their behaviors and environments to standardize care processes in widely varying hospital settings.
Patient Safety Programme, World Health Organization, WHO/HIS/PSP, Avenue Appia 20, CH-1211 Geneva, Switzerland. leotsakosa@who.int.
Agnès
A
Leotsakos
Hao
H
Zheng
Rick
R
Croteau
Jerod M
JM
Loeb
Heather
H
Sherman
Carolyn
C
Hoffman
Louise
L
Morganstein
Dennis
D
O'Leary
Charles
C
Bruneau
Peter
P
Lee
Margaret
M
Duguid
Christian
C
Thomeczek
Erica
E
van der Schrieck-De Loos
Bill
B
Munier
D003142:Communication; D063373:Hand Hygiene / Q000592:standards; D006739:Hospital Administration / Q000592:standards*; D006801:Humans; D007267:Injections / Q000592:standards; D038622:Internationality; D008508:Medication Errors / Q000517:prevention & control; D059065:Medication Reconciliation / Q000592:standards; D062209:Patient Handoff / Q000592:standards; D061214:Patient Safety / Q000592:standards*; D013514:Surgical Procedures, Operative / Q000592:standards; D014944:World Health Organization
evaluation; medication safety; patient safety; standard operating protocol; standardization; surgical safety