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The Top Six: standardized safety practices in U.S. Army Medical Department treatment facilities worldwide.
February 23, 2022
Hartstein B, Munante M, Toor PA. NEJM Catal Innov Care Deliv. 2022;3(2):e1-e20.
High-reliability organizations (HROs) are able to “manage the unexpected” while operating under challenging conditions. This article describes the U.S. Medical Department’s systemwide rollout of the Top Six HRO communication practices. The authors summarize how the Top Six campaign was developed and discuss the implementation of six systemwide initiatives to increase reliability – (1) daily safety briefings; (2) safety leadership rounds; (3) unit-based huddles; (4) Situation Background Assessment Recommendation (SBAR) for communication; (5) briefs and debriefs for surgical cases; and (6) Universal Protocol before every procedure.
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