During Patient Safety Awareness Week, the Indian Health Service proudly joins healthcare organizations nationwide in recognizing the 2026 theme: “Team Up for Patient Safety.”
At IHS, patient safety is not the responsibility of a single role or department; it is a shared commitment embraced by every member of our team. From clinicians providing direct care to Environmental Services staff ensuring clean and safe environments, from Human Resources professionals supporting our workforce to acquisitions teams securing essential equipment and services, every role contributes to protecting our patients and communities.
Equally important are our patients and families, who partner with us in care and help strengthen our culture of trust and transparency. Together, we are one team.
Advancing Total System Safety
Over the past two years, IHS has accelerated the implementation of its Total System Safety (TSS) Strategy, embedding it into the agency’s strategic plan under Goal 1: Be a Leading Healthcare Organization.
In 2025, the IHS Patient Safety Program achieved significant milestones:
- 187 staff funded to complete Institute for Healthcare Improvement Root Cause Analysis and Action training;
- 80 executive leaders trained through the Veterans Health Administration Patient Safety Executive Seminar;
- 111 staff trained in proactive risk assessment methodologies; and
- Development and rollout of standardized safety processes, including Leadership Rounds, Inpatient Fall Prevention, Closed-Loop Communication, and Surveys on Patient Safety Culture.
These efforts strengthen reliability, consistency, and learning across the agency.
A Growing Culture of Speaking Up
One important indicator of a strong safety culture is the proportion of reported “good catches,” which are near misses identified before harm occurs, compared to total reported events.
Over the past year, IHS has seen a steady increase in the ratio of good catches to total events, reaching approximately 23 percent in recent months. This upward trend reflects a growing culture of speaking up, psychological safety, and proactive risk identification.
In high-reliability organizations, increased reporting of near misses is a positive sign. It demonstrates trust in the system and a shared commitment to identifying vulnerabilities before harm occurs. This reflects a core principle of Total System Safety: maintaining a preoccupation with failure, actively looking for risks so they can be addressed before patients are affected.
Measurable Improvements in Accountability and Learning
IHS has also made substantial progress in standardizing Root Cause Analysis processes. Between 2023 and 2025, the percentage of high-risk events documented with a completed Root Cause Analysis increased from four percent to more than 90 percent. Additionally, through structured closed-loop communication with facility leadership, overdue high-risk events were reduced from 50 percent to four percent, a 98 percent decrease.
These measurable improvements demonstrate IHS’s commitment to accountability, learning, and system-level improvement.
Recognizing Good Catches and Patient Safety Excellence
In anticipation of Patient Safety Awareness Week, IHS hosted a Good Catch Competition in January and February to recognize facilities demonstrating strong reporting practices and proactive risk identification.
Overall Winners
- Yakama Health Center (Portland Area) – 1st Place
- Wewoka Indian Health Center (Oklahoma City Area) – 2nd Place
- Woodrow Wilson Keeble Memorial Healthcare Center (Great Plains Area) – 3rd Place
January Winners
- Hospital: Gallup Indian Medical Center (Navajo Area)
- Critical Access Hospital: Cass Lake Hospital (Bemidji Area)
- Ambulatory: Woodrow Wilson Keeble Memorial Healthcare Center (Great Plains Area)
- Youth Regional Treatment Center: Desert Visions (Phoenix Area)
February Winners
- Hospital: Phoenix Indian Medical Center (Phoenix Area)
- Critical Access Hospital: Fort Yates Hospital (Great Plains Area)
- Ambulatory: Wewoka Indian Health Center (Oklahoma City Area)
- Youth Regional Treatment Center: Sacred Oaks (California Area)
To view the full list of Good Catch winners, visit Preoccupation with Failure Awards 2026
Celebrating Peer Recognition in Patient Safety
Equally inspiring is the number of staff who took the time to nominate their colleagues for Patient Safety Excellence. These nominations reflect a culture of teamwork, respect, and shared accountability, where staff recognize one another for protecting patients, speaking up, and improving systems.
To view this year’s Patient Safety Excellence nominees, visit: Patient Safety Excellence Nominations - 2026
Recognizing the contributions of others strengthens our safety culture and reinforces that every voice matters.
Safety Every Day
Patient Safety Awareness Week is an opportunity to celebrate progress and recognize excellence, but at IHS, safety is a daily commitment.
Through Total System Safety, standardized processes, workforce training, leadership engagement, and a growing culture of reporting and learning, IHS continues to build a safer system for patients, families, and the workforce.
Thank you for teaming up for patient safety this week and every day.
For more information on IHS Patient Safety processes and initiatives, visit the Patient Safety SharePoint page.
