Patient safety

Action on Patient Safety - High 5s

Project plan

A High 5s Steering Group was established in 2006 to determine the overall architecture of the initiative. The project is being implemented in three phases.

The first phase (2006-2008), initiated in late 2006, has involved the identification of five evidence-based solutions for patient safety and the development of a Standard Operating Protocol (SOP) for each solution. The solutions are:

  • Managing Concentrated Injectable Medicines;
  • Assuring Medication Accuracy at Transitions in Care;
  • Communication During Patient Care Handovers;
  • Improved Hand Hygiene to Prevent Health Care-Associated Infections; and
  • Performance of Correct Procedure at Correct Body Sites

Each solution summarizes the problem, the strength of evidence that supports the solution, potential barriers to adoption, potential unintended consequences created by the solution, patient and family roles in the solution, and references and resources. The SOPs provide specific guidance for implementing the solutions in countries participating in the High 5s initiative.

The second phase (2008 -2010) will identify a lead technical agency in each participating country to coordinate the High 5s initiative at the country level. Each agency will enroll approximately 10 hospitals in the project, and each hospital will select up to five SOPs to implement. Participating hospitals will be given high visibility and recognition for their acceptance of this challenge and for their leadership in standardizing patient care practices.

The lead technical agency within each country will coordinate and support the implementation of SOPs at participating hospitals, and monitor progress of the impacts of the SOPs. These hospitals will compose an international learning laboratory in which the solutions’ effect upon health care delivery and patient safety can be monitored. The impact evaluation strategy will focus on correlating the underlying causes of adverse events and indicator events with SOP implementation, tracking changes in the safety culture within participating hospitals.

Impact will be measured using the following tools:

  • Root cause analyses of indicator events and other adverse events
  • Patient safety indicators
  • Cultural assessments
  • Economic impact indices.

Collected data from participating hospitals will be submitted to the WHO Collaborating Centre for Patient Safety for analysis, tracking and for dissemination and exchange of knowledge to support effective solution implementation.

The third phase (2010-2011) Over time, the project will encourage participating countries to use their established relationships with other countries—particularly developing and transitional countries—to transfer the knowledge necessary to facilitate the systematic implementation of patient safety solutions in these additional countries.