In recent years, quality and safety in patient healthcare has become an important professional and academic field, involving practical scientific research with far-reaching implications in the areas of organization of the workplace, medical education and legislation.  During 2002, Prof. Shlomo Mor-Yosef, the Director-General of the Hadassah Medical Organization, established a hospital committee for clinical quality improvement and error prevention.  This committee serves as a quality control unit as defined in the Patients’ Rights Law.  Its principal function is to encourage and initiate measurement of clinical quality parameters in hospital departments, under the supervision of the department chairman, with the cooperation of doctors and nurses as well as medical, public health and nursing students (as a final paper or thesis project).  The long-term goal is to change the organizational culture, leading to the routine measuring of quality indicators.

Due to the backlog of projects, it was decided in March 2003 to establish the Center for Quality and Safety in order to assist the committee in its endeavors.  The Center was requested to develop new methods for evaluating and improving clinical performance through the application of industrial (of the statistical-process-control type), communication and organizational psychology instruments.

In a fourth year of activity, a variety of projects for clinical quality & safety are being conducted at both Hadassah hospitals.  Some areas show opportunities for, or demonstration of, improvement.  These include:

·        Patients' empowerment to improve oral anticoagulation

·        Peri-operative antibiotic prophylaxis

·        Safety of medications storage in wards

·        Quality of communication between hospital and family physicians

·        Reduction of medication and surgical errors

·        Improved glucose control for patients with diabetes

·        Respiratory support in patients outside intensive care units

·        Patient involvement in urinary tract infection

·        Cardiac rehabilitation for coronary disease

·        Correct estimation of fetal weight in pregnancy

·        Palliative care

·        Team hand-washing using alcohol gel

·        Infections in surgical wards

·        Hadassah projects for promotion of community healthcare quality

Several national projects suggest fair or superior performance at Hadassah in trauma, neonatal care and intensive care.  Institution-wide challenges for the near future include: reduction of hospital-acquired infections and comprehensive electronic support for quality & safety.

Other activities consist of workshops, presentations and publications at national and international platforms, including 36 abstracts presented at the 2005 meeting of the Israeli Society for Quality in Medicine. 

In conclusion, diverse projects attempt to make healthcare at Hadassah more patient-centered, more evidence-based and more system-minded.  Increasing accountability by department heads for quality and safety may be a key to further successes.  

The Center for Clinical Quality and Safety is a small team coaching students from the Faculty of Medicine on projects in quality.  The Committee for Quality & Safety oversees a variety of projects on patients' safety and satisfaction.