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J Healthc Risk Manag. 2012;32(2):4-18. doi: 10.1002/jhrm.21090.

Our journey to zero: reducing serious safety events by over 70% through high-reliability techniques and workforce engagement.


The techniques and best practices used to achieve a successful safety culture transformation and drive down the incidence of serious safety events are described. The Safety Transformation Initiative at Children's National resulted in national and local recognition, a financial savings of an imputed $35 million, and a greater than 70% decrease in the serious safety event rate over a 3-year period (July 1, 2008-June 30, 2011). The results were achieved during a time of significant financial constraints and with limited resources. A blueprint detailing specifics of the implementation is presented to assist others in achieving similar results. Our safety transformation was initiated in our fiscal year 2009 as part of a 3-year corporate goal. The work is continuing and we aspire to virtually eliminate serious safety events by 2016.

© 2012 American Society for Healthcare Risk Management of the American Hospital Association.

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