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- strategic plan
- patient-family centeredness
- Institute of Medicine quality domains
- quality improvement
- patient safety
- patient harm
- efficient care
- equitable care
- pediatrics
- IOM —
- Institute of Medicine
Strategic plans provide the roadmap by which organizations achieve their vision. To effectively serve as that roadmap, strategic plans must have certain essential characteristics. These include the ability to inspire and motivate while remaining action-oriented and understandable to all personnel. More than a decade ago, in Crossing the Quality Chasm,1 the Institute of Medicine (IOM) suggested organizing transformational efforts in 6 domains: Safety, Effectiveness, Patient-Family Centeredness, Timeliness, Efficiency, and Equity. Recently 2 additional domains have been added: Access and Care Coordination. Since that time, many quality and safety efforts and hospital strategic plans have been built around those domains. Although the IOM structure is succinct, the domains important, and the strategic vision thorough, it did not inspire or motivate our staff sufficiently to be the framework for change in our hospital. Therefore, Nationwide Children’s Hospital developed a strategic plan, organized entirely from the point of view of the patient and family. We believe this quality and safety strategic plan is readily understandable by all, more motivational because of its direct link to the patient, and offers an effective alternative to the IOM domains of transformative strategic thinking (Table 1).
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IOM Domains Compared With National Children’s Hospital Quality and Safety Strategic Plan Domains
The plan has 5 pillars/domains: (1) Do not harm me, (2) Cure me, (3) Treat me with respect, (4) Navigate my care, and (5) Keep us well. This language is understandable at all levels in the organization—from front line staff to the board of directors. Although the IOM terminology articulates the intellectual content of the domains (“the head”), our terminology …
Address correspondence to Richard J. Brilli, MD, 7th Floor Administration, Nationwide Children’s Hospital, 700 Children’s Dr, Columbus, OH 43205. E-mail: rbrilli{at}nationwidechildrens.org
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