title: The Armstrong Institute: An Academic Institute for Patient Safety and Quality Improvement, Research, Training, and Practice.
abstract: Academic medical centers (AMCs) could advance the science of health care delivery, improve patient safety and quality improvement, and enhance value, but many centers have fragmented efforts with little accountability. Johns Hopkins Medicine, the AMC under which the Johns Hopkins University School of Medicine and the Johns Hopkins Health System are organized, experienced similar challenges, with operational patient safety and quality leadership separate from safety and quality-related research efforts. To unite efforts and establish accountability, the Armstrong Institute for Patient Safety and Quality was created in 2011.The authors describe the development, purpose, governance, function, and challenges of the institute to help other AMCs replicate it and accelerate safety and quality improvement. The purpose is to partner with patients, their loved ones, and all interested parties to end preventable harm, continuously improve patient outcomes and experience, and eliminate waste in health care. A governance structure was created, with care mapped into seven categories, to oversee the quality and safety of all patients treated at a Johns Hopkins Medicine entity. The governance has a Patient Safety and Quality Board Committee that sets strategic goals, and the institute communicates these goals throughout the health system and supports personnel in meeting these goals. The institute is organized into 13 functional councils reflecting their behaviors and purpose. The institute works daily to build the capacity of clinicians trained in safety and quality through established programs, advance improvement science, and implement and evaluate interventions to improve the quality of care and safety of patients.
authors.affiliation: P.J. Pronovost is senior vice president of quality and safety, Johns Hopkins Medicine; director, Armstrong Institute for Patient Safety and Quality, Johns Hopkins Medicine; and professor, Departments of Anesthesiology and Critical Care Medicine and Surgery, School of Medicine; professor, Department of Health Policy and Management, Bloomberg School of Public Health; and professor, School of Nursing and Carey Business School, Johns Hopkins University, Baltimore, Maryland.C.G. Holzmueller is senior medical writer and editor, Armstrong Institute for Patient Safety and Quality, Johns Hopkins Medicine, and senior research program coordinator II, Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.N.E. Molello is administrator, Armstrong Institute for Patient Safety and Quality, Johns Hopkins Medicine, and Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.L. Paine is director of patient safety, Armstrong Institute for Patient Safety and Quality, Johns Hopkins Medicine, and Johns Hopkins University School of Medicine, Baltimore, Maryland.L. Winner is director of Lean Sigma deployment, Armstrong Institute for Patient Safety and Quality, Johns Hopkins Medicine, Baltimore, Maryland.J.A. Marsteller is associate professor, Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, and Armstrong Institute for Patient Safety and Quality, Johns Hopkins Medicine, Baltimore, Maryland.S.M. Berenholtz is professor, Armstrong Institute for Patient Safety and Quality, Johns Hopkins Medicine, Departments of Anesthesiology and Critical Care Medicine and Surgery, School of Medicine, and Department of Health Policy and Management, School of Public Health, Johns Hopkins University, Baltimore, Maryland.H.J. Aboumatar is assistant professor, Department of Medicine, Johns Hopkins University School of Medicine, and Armstron
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Pronovost
authors.forename: Christine G
authors.initials: CG
authors.lastname: Holzmueller
authors.forename: Nancy E
authors.initials: NE
authors.lastname: Molello
authors.forename: Lori
authors.initials: L
authors.lastname: Paine
authors.forename: Laura
authors.initials: L
authors.lastname: Winner
authors.forename: Jill A
authors.initials: JA
authors.lastname: Marsteller
authors.forename: Sean M
authors.initials: SM
authors.lastname: Berenholtz
authors.forename: Hanan J
authors.initials: HJ
authors.lastname: Aboumatar
authors.forename: Renee
authors.initials: R
authors.lastname: Demski
authors.forename: C Michael
authors.initials: CM
authors.lastname: Armstrong
mesh_terms: D000046:Academic Medical Centers; D000047:Academies and Institutes; D015142:Baltimore; D003695:Delivery of Health Care; D006801:Humans; D007857:Leadership; D061214:Patient Safety; D058996:Quality Improvement; D011787:Quality of Health Care; D012106:Research