The Institute of Medicine report

Continuous quality improvement involves every level of the healthcare organization. A master’s-prepared nurse must be articulate in the methods, tools, performance measures, culture of safety principles, and standards related to quality, as well as prepared to apply quality principles within an organization to be an effective leader and change agent. The Institute of Medicine report (1998) To Err is Human defined patient safety as “freedom from accidental injury” and stated that patients should not be at greater risk for accidental injury in a hospital or healthcare setting than they are in their own home. Improvement in patient safety along with reducing and ultimately eliminating harm to patients is fundamental to quality care. Skills are needed that assist in identifying actual or potential failures in processes and systems that lead to breakdowns and errors and then redesigning processes to make patients safe.

Knowledge and skills in human factors and basic safety design principles that affect unsafe practices are essential. Graduates of master’s-level programs must be able to analyze systems and work to create a just culture of safety in which personnel feel comfortable disclosing errors—including their own—while maintaining professional

Knowledge and skills in human factors and basic safety design principles that affect unsafe practices are essential. Graduates of master’s-level programs must be able to analyze systems and work to create a just culture of safety in which personnel feel comfortable disclosing errors—including their own—while maintaining professional

14

accountability. Learning how to evaluate, calculate, and improve the overall reliability of processes are core skills needed by master’s-prepared nurses.

The Institute of Medicine report Knowledge of both the potential and the actual impact of national patient safety resources, initiatives, and regulations and the use of national benchmarks are required. Changes in healthcare reimbursement with the introduction of Medicare’s list of “never events” and the regulatory push for more transparency on quality outcomes require graduates to be able to determine if the outcomes of standards of practice, performance, and competence have been met and maintained.