Imagine if your loved one went in for surgery to replace a right knee and woke up having had your left knee operated on instead. What if you took your 12-year-old son with a high fever, vomiting, and severe stomach pain to see your pediatrician and were told he had a stomach bug and not to worry, only to have him die of sepsis two days later? We all expect the healthcare that we receive to be the highest quality possible, in whatever setting is offering the care. We expect our care to be safe, effective, patient-centered, timely, efficient, and equitable. We don't expect to be harmed or die as a result of care, yet unfortunately, all too many of us are not not getting the quality of care we expect and deserve. Hi, my name is Dr. Jean Johnson, and I'd like to welcome you to the course. I'm the founding Dean and a professor at the George Washington University School of Nursing. As a nurse who's been involved in quality improvement efforts for most of my career, I have focused on examining the role of the survey process in improving care in nursing homes, as well as, working with policy makers to integrate quality improvement programs in nursing homes in many states across the US. I've also worked to develop the quality and safety education for nurses, otherwise known as QSEN. Those modules were funded by the Robert Wood Johnson Foundation, which had been integrated into undergraduate and graduate nursing programs nationwide. During my tenure as Dean of the School of Nursing, I also worked to offer the first master's level program in healthcare quality, and also a specialty area in quality improvement for the Doctor of Nursing Practice students. My partner in teaching this course is Dr. Gregory Pawlson, a physician who has also spent much of his career working on improving healthcare quality. >> Welcome, my name is Greg Pawlson, and I am a physician with a longstanding commitment to understanding, measuring, and improving the quality of healthcare. Early in my career I was engaged in research on outcomes of care and created innovative approaches to measuring quality provided by a geriatric service, as well as leading a department of primary care at George Washington University. In the year 2000, I became the Executive Vice President of the National Committee for Quality Assurance, or NCQA. In that role I had the opportunity to participate in the development and reporting of measures of quality in health plans, in physician offices, and in other clinical settings. Since leaving NCQA, I've continued my efforts in improving healthcare, working with a law firm of Saxton and Stump, advising strategies to reduce medical errors in physician practices. Doctors, nurses, and others providing healthcare go to work every day intending to provide good care for their patients. They adhere to the ancient Greek dictum of, "First do no harm", and they believe that they provide the best care possible. Yet the seminal report from the US Institute of Medicine, that captured people's attention in 1999, indicated that nearly 100,000 people die in US hospitals from medical errors and quality lapses every year. That's the equivalent of a jumbo jet crashing every single day. We're exacting calculations from the work of John James and others, suggests that the number may actually be much higher, upwards of a quarter of a million, to 400,000 a year. More recent evidence suggests that the situation has improved in many areas, but overall, the improvement is still only marginal. The Centers for Medicare and Medicaid released data indicating that although 2.1 million fewer patients were harmed by hospital acquired infections between 2010 and 2014, there has been little progress on injury from falls and from misdiagnosis. Evidence from other countries shows that medical errors in hospitals are a significant cause of death around the world. As healthcare providers we believe we are providing excellent care. But objective studies indicate that in all to many instances that is not always the case. Why do we have such and unacceptable rate of medical errors and poor quality? Empiric studies of quality and safety suggest it is because we have not paid sufficient attention to building quality and safety into the technologies and the systems that we use. Or indeed, into the education of those of us who provide the care. Or to measuring, monitoring, and improving quality and safety. In this course, we'll take a closer look at each of these contributing factors. And provide you with an overview of strategies and skills that can start you on the path to lead, or at least participate in, critical quality and safety improvement initiatives in your own practice setting. >> We're excited to be working with you and others like you who are interested in making a difference in the quality of healthcare around the world. Active involvement in quality and safety can save and improve lives just as surely as administering antibiotics to someone with pneumonia. We encourage you to connect, share experiences, and build a rich community of learning and practice. So, let's get started.