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7.7: Summary

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    This chapter introduced the philosophy of QM in health care and highlighted events across the international health care environment that have put a focus on patient safety culture, such as the development of Magnet hospitals in the US and the Francis inquiry in the UK. In addition, common QI approaches such as Magnet hospitals and Lean were described and discussed, with a focus on their contribution to patient safety. Finally, PDSA, a prevalent QI tool, was introduced.

    After completing this chapter, you should now be able to:

    1. Describe the key issues leading to the development of Magnet hospitals.
    2. Identify how Magnet hospitals changed health care in the United States.
    3. Describe the key issues leading to the publication of the Francis report in the UK.
    4. Describe the features of “a culture of safety.”
    5. Appraise the use of Lean in health care.
    6. Appraise the plan-do-study-act (PDSA) cycle as a basis for QI work.
    7. Identify your leadership imperative to create safe work environments and support QI work.


    1. Apply the proposed 2014 NHS framework for measuring and monitoring safety to a hospital where you have had a clinical placement. Can you see areas for improvement in measurement and monitoring of safety?
    2. You are the director of nursing for a long-term care facility. When an elderly woman falls out of her bed during the night and breaks her hip, you look at recent incident reports and notice that there has been an increase in residents’ nighttime falls. Use the PDSA QI tool to find a solution that will reduce the nighttime falls of residents.


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    7.7: Summary is shared under a CC BY 4.0 license and was authored, remixed, and/or curated by Joan Wagner via source content that was edited to conform to the style and standards of the LibreTexts platform; a detailed edit history is available upon request.