High Reliability: For Patients and Providers

In order for our health system to ensure patients receive safe care there must be high reliability in the system. Providers need the system to support them so that they can concentrate on providing the best care possible to their patients. How do we build high reliability organizations? Today we learned several characteristics of a high reliability organization including process design, reliability culture, human factors integration, patient/family partnerships and transparency. There are also several tools that go along with this (leadership safety rounds, daily safety huddles, stop the line, checklists, ect). So far through this camp I have put an emphasis on communication, both interprofessionally and with patients. I think communication is the most important factor in improving patient safety however in this environment we have been surrounded with people who have a shared vision. One of the most important characteristics of creating a high reliability organization to improve patient safety is culture.

Culture influences the way people think, speak and act on patient safety and from what I have heard changing culture is the hardest thing to do. I was speaking with Joe, one of the nursing students while we were discussing ways we as students can use these high reliability tools in our organizations. He mentioned that without leadership support these efforts can be in vain, to which I agree. Being an administrative student, I recognize the need for leadership driven change. Cultural changes take a commitment and unrelenting pursuit of the vision. Throughout this week I have recognized the power of learning how different healthcare professionals are trained and how they think clinically. Being able to communicate this understanding of their work and utilizing leadership safety rounds on the gemba will allow me to partner with providers to help create a lasting cultural change. Most healthcare professionals enter this field because they want to help patients get better, which makes establishing a mutual purpose fairly simple. As an administrator identifying and empowering clinical champions in a cultural change is critical in helping gain the momentum needed to make the shift stick.

As this week has gone by I have realized more and more the importance of teaming for patient safety. For organizations to be highly reliable the members of that organization must function as a team, effectively communicating with one another. Together we can change not only the culture of our organizations, but the culture of healthcare where errors and patient harms are no longer expected outcomes of care but rather occurrences that can be minimized through high reliability and caught before they cause serious harm. As John Nance says, we are all carbon based units, and we are going to make mistakes, but I believe by teaming and communicating we can build a system that is just as safe a aviation, nuclear power or the military.