[MUSIC] Hi, in this lesson, we're going to talk about the history of quality improvement and patient safety from 1966 to the present. In 1979, the Accreditation Association for Ambulatory Healthcare was formed. This was important because it assisted ambulatory healthcare organizations to improve the quality of care provided to patients in this setting. In 1989, the Agency for Health Care Policy and Research was created under the Omnibus Budget Reconciliation Act of 1989. It was renamed the Agency for Healthcare Research and Quality, what is now known as AHRQ, as part of the Healthcare Research and Quality Act of 1999. The purpose of AHRQ is to produce evidence to make health care safer, higher quality, more accessible, equitable, and affordable, and to ensure that the evidence is understood and used. In 1990, the National Committee for Quality Assurance, what is known as the NCQA, was mandated to offer accreditation programs for health care plans. They assumed responsibility for the health plan employer data and information set, which is known as HEDIS. HEDIS is a tool used by health plans to measure performance on important dimensions of care and services provided to members of these plans. And health plans that report HEDIS data to employers, and they use these results to make improvements in the quality of care and service it provides to those plans. In 1991, the Institute for Healthcare Improvement was founded, and it focused on the identification and spread of best practices in quality and safety. In 1994, Dr. Lucian Leape published Error in Medicine. This was an early paper, and it called for the application of systems theory to prevent medical errors. We've included a copy of that as available for your reading. In 1999, the Institute of Medicine published the landmark report called To Err is Human, Building a Safer Health System. We'll have an entire video dedicated to just this landmark paper. In 2001, the Institute of Medicine published a follow up report to To Err Is Human called Crossing the Quality Chasm, A New Health System for the 21st Century. We will also dedicate an entire lesson to this topic. In 2001, Dr. Peter Pronovost published on a simple five-item checklist that led to significant reductions in central line infections. In 2003, he implemented this five-item checklist in the Michigan Keystone Initiative which led to an estimated savings of $100 million and 1500 lives saved across that state. This summarizes the major events in quality improvement and patient safety from 1966 to the present. As you can see from these two videos, we've had a lot of important events that contributed to where we are in quality and safety. But what we're going to talk about later is how far we still have to go to really eliminate preventable harm for our patients.