![]() ![]() ![]() I-PASS is an evidence-based handoff bundle, 8 which was implemented and rigorously studied on non-ICU inpatient “medical-surgical” units at 9 North American pediatrics residency programs. 7 In all these campaigns, the purpose was to use process measures (ie, behavior and systems-level changes) to achieve outcome measures (ie, increased value, decreased harms). 6 Similarly the 100,000 Lives Campaign galvanized energy and attention around patient safety with a focus on evidence-based steps to reduce patient deaths. 5 The Surviving Sepsis campaign sponsored by the Society of Critical Care Medicine has led to implementation of best practices to reduce preventable death from sepsis. The Choosing Wisely campaign, led by the American Board of Internal Medicine Foundation, has been successful at engaging all major medical specialties to develop specific evidence-based recommendations intended to reduce unnecessary care. In addition to using business change models, medical experts have used campaigns to engage physicians in desirable behaviors. 1 This change must be aligned with the mission, vision, and values of the institution. Within academic medical centers, physician champions and high-level leaders are essential to drive behavior change. In Kotter’s 8-step model 4 (outlined in Table Table1), 1), the key steps in effecting transformational change include establishing a sense of urgency, building a powerful guiding coalition of leaders, creating and communicating the vision, empowering others to act on the vision, planning for and creating short-term wins, consolidating improvements, and institutionalizing new approaches effectively. Successful models for leading transformational organizational change have been described in the business literature. 3 Targeted leadership, support, and motivation may be required to drive behavior change among physicians. 1 Although innovations may diffuse passively within health care systems, 2 it has been estimated to take 17 years from the time a discovery is made until universal practice change is achieved. However, behavior change is notoriously difficult to achieve. Academic medical centers routinely engage in evidence-based practice.
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