Posted January 13, 2017

Building High Reliability Organizations (HROs) in Healthcare

The challenge of building high reliability organizations (HROs) in healthcare was a hot topic at What's Right in Health Care® 2016. It's also the focus of Part 3 of our 7-part series on the 2016 edition of one of healthcare's largest conferences. Previously, we reviewed insights and ideas from healthcare leaders who have been making important strides in staff and physician engagement. Part 4 will look at the rapid pace of change and disruption in healthcare - another hot topic at What's Right in Health Care 2016.

The performance improvements underway at leading healthcare organizations are substantial, measurable and often highly innovative. But for the industry as a whole, across the spectrum of care, there is still a lot of work to do.

This challenge was articulated by Dr. Mark Chassin, president and CEO of The Joint Commission, the predominant healthcare accrediting body in the U.S., with performance standards and certifications that are recognized worldwide. Dr. Chassin's message was clear: despite nearly two decades of intense improvement efforts, healthcare continues to be plagued by serious quality and safety problems. Too many patients suffer from preventable infections, falls with injury, medication errors and other adverse events. "We have made progress," he acknowledged, "but we haven't made enough progress. We still see routine safety procedures failing routinely".

Health leaders know they must ultimately get to always - quality and safety for every patient, every time, across the entire health system. This is the challenge of high reliability.

Dr. Chassin advocates high reliability, with the ultimate goal of zero harm. There are lessons to be learned from other industries such as airlines and nuclear power that have achieved and sustained near-perfect safety records. Many safety and quality efforts in healthcare are still applied on a project-by-project basis that may produce results but is rarely sustainable and never leads to zero harm.

The Center for Transforming Health Care has been established by The Joint Commission, a Studer Group partner, to support high reliability in healthcare. It has developed a model that incorporates a strong emphasis on leadership - all leaders must be fully committed and focused on quality and safety as the top strategic goal - along with a safety culture and robust process improvement (RPI), including Lean and Six Sigma implemented in the context of effective change management.

These ideas were familiar to many conference attendees. Evidence-Based LeadershipSM is widely used to build a culture of alignment and accountability focused on key quality and safety goals. This serves as the "foundation" that enables process improvement tools like Lean and Six Sigma to be implemented successfully and sustained over time. These tools, along with many other systems and behaviors, operate more predictably and efficiently within an organization-wide approach aimed at "always" - every patient, every time. This comprehensive change management framework, with coordinated processes of continuous improvement all driving toward always, is fully aligned with the concept of high reliability.

Dr. Chassin argued strongly that principles like these, and the ultimate goal of zero harm, can no longer be viewed as something pursued selectively by leading organizations; they are essential standards that must be applied universally, across health systems.

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