The High 5s Initiative

Established through collaboration between the Commonwealth Fund, the WHO World Alliance for Patient Safety and the WHO Collaborating Centre for Patient Safety, the High 5s initiative is a mechanism to implement innovative, standardized operating protocols for five patient safety solutions over five years. This initiative seeks to leverage the implementation of solutions that would have broad impacts in preventing avoidable catastrophic adverse events — death or serious injury — in hospitals.

The following five solution areas have been selected as the focus of the High 5s initiative:

  • Prevention of patient care hand-over errors
  • Prevention of wrong site / wrong procedure / wrong person surgical errors
  • Prevention of continuity of medication errors
  • Prevention of high concentration drug errors
  • Promotion of effective hand hygiene practices

The High-5s initiative builds on the partnership established by the Commonwealth Fund with Australia, Canada, New Zealand, the United Kingdom, and the United States of America, and the more recent expansion of this international programme to include Germany and the Netherlands.

Within each country, a designated lead technical agency will enroll approximately 10 hospitals to implement standardized operating protocols for up to five patient safety solutions identified for inclusion in the High 5s project. These hospitals will compose an international learning laboratory in which the solutions’ effect upon health care delivery and patient safety can be monitored. 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

Ongoing learning will be disseminated worldwide through a High 5s web site.

Over time, the project will encourage participating countries to use their established relationships with other nations—particularly developing and transitional countries—to transfer the knowledge necessary to facilitate the systematic implementation of patient safety solutions in these additional countries. The High 5s project aims to achieve significant, sustained and measurable reduction in the existence of identified threats to patient safety and to build an international, collaborative learning network that fosters the sharing of knowledge and experience in implementing patient safety solutions.

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