High-Reliability Organizations and Patient Safety


Despite widespread and serious effort to enhance healthcare quality, a number of patients still suffer from preventable conditions each day. Hospitals find it hard to sustain improvement and they mostly suffer from project fatigue due to a number of issues that need their attention. According to Chassin and Loeb (2013), no health system or hospitals have attained consistent excellence in their entire institution. The science of high-reliability is the organizations study in industries such as nuclear power and commercial aviation that work under hazardous condition while upholding safety levels which are far better compared to those of healthcare. Applying and adapting the high-reliability concept to health care provides the promise of allowing hospitals to attain levels of safety and quality which are comparable to the above mentioned organization. This paper focuses on discussing measures that can be employed to make health care organization highly reliable.

Concept of High-Reliability Organizations and how they can Transform Health Care

High-reliability organizations (HROs) refer to those organizations which exist in in hazardous settings where errors consequences are high, but errors occurrence is extremely low. Some of these organizations include wildland firefighting, electric power grid, and aircraft carrier. These companies have the ability for disastrous failure though they are involved in almost error-free performance. HROs pledge to safety at the greatest level and employ a special technique to its pursuit (Chrustuanson et al., 2011). High reliability science is receiving great attention in health care organization, especially in high-risk environments that include intensive care unit. To achieve this, health care organizations should set principles which permit them organizations to center their attention on developing issues and to set up the right set of resources to handle the identified issues.

Similar to other High-Reliability Organization, health care organizations should take failures positively and perceive them as a chance to improve the system for better outcome. Health care organizations should stop focusing on one aspect of the problem or work, but consider on improving the entire system as a whole. They should also look forward to experience unexpected events and create measures to manage them. This can be effectively achieved by employing experts to define a comprehensive problem solving mechanism that consider all aspects of system operation (Chrustuanson et al., 2011). Most high-reliability organizations have tried to automate their system to enhance efficiency. Although this cannot be wholly achieved in healthcare organization, automation should be maximized to the highest level possible to minimize errors. Teamwork is another aspect that is likely to increase healthcare organizations reliability. Team members normally have different attitudes, skills and knowledge. This means working in collaboration to attain the organization goals will highly promote efficiency, minimization of errors and safety promotion in health care organization (Sutcliffe, 2011).

The Reason for Little Progress in Healthcare toward Becoming an HRO

There has been application of wide range of health care quality improvement efforts in the past. Some of these efforts include care system reengineering, improving physician peer review practice, applying progressive quality enhancement, restructuring professional education, and punishing poor performance among others. In some cases, the healthcare organizations have been successful in their attempts to vexing safety and quality issues. However, these victories have been short lived. Thus the past employed measures have not been successful in solving deeply rooted, persistent and complex safety and quality issues (Chassin& Loeb, 2011). Some of the challenges that have contributed to unsuccessful long term measures or changes in healthcare organizations include the changing sources of problems.

Basically, healthcare organizations handle a wide range of problems which keep on changing in their intensity and volume. There are always new diseases which demand new safety measures based on their severity. These condition may be very new such that there are no medics with comprehensive knowledge on how to handle them. When such condition erupt, the erroneous procedures are inevitable in any healthcare organization. Beside this, there could be outbreak of known condition, creating pressure to the available healthcare organizations resources which include human resource. In such situation, it is considerably hard to maintain high quality services at the required urgency (Chassin& Loeb, 2011). Healthcare organizations also deal with disease pathogens which keep on mutating to build resistance such that, previously employed measure may not be viable to handle a pathogen after its mutations. This means, changes need to be made frequently as the situation change to maintain high quality of care. The changes normally create a need to going back to the drawing board to find a new solution or strategy. Moreover, new things regarding the known issues are always discovered in medical research. This implies that the find lacks comprehensive knowledge on issues facing it. Thus, it is definitely hard to define a comprehensive solution to these problems. Medical issues are very many and diverse, and each issue may need a new technique to handle it. This in most cases becomes uneconomical and complex to develop a high-reliable organization in terms of quality of care and safety (May, 2013).

Improvement that can be made by Health Care Organization to Become High-Reliability Organization

There are a number of measures that can be employed by the healthcare organizations to strive to become High-Reliability Organizations. Some of these measures include adopting transformational culture which initiates the desire to improve the situation at all the time. Transformational culture will assist an organization to always work toward improving its current state to better its performance. Leaders in this case will have the major role in influencing followers to be innovative, independent and determined to meet new personal and organizational development goals. Improving the organization level of collaboration and teamwork can also play a great deal in improving the situation (May, 2013). Teamwork promote sharing of knowledge and ideas, and working in coordination among all personnel in the organization to achieve better results. An organization should also try to improve its operation model by improving on supervision, accountability and effectiveness in offering services and using resources (Sparnon&Marella,2012).  Patients should be requested to provide feedback on services received, while the organization management uses the provided feedback to streamline the operations in the organization. The organization management should try to provide all the resources needed to enhance efficiency, quality and safety in a healthcare organization. Personnel development through training on new issues and personal growth through knowledge advancement should be embraced and encouraged in a healthcare organization. Rewarding system which focuses on performance recognition should also be adopted to motivate workers towards fulfilling the organization mission and vision, especially with regard to quality of care, safety and efficiency.

Potential Interest of the Payer in an HRO

Payer focuses on reducing cost and maximizing on the utilization of the available resources. The potential payer will therefore be interest in the organization ability to reduce or completely eliminate preventable risks that can increase payer’s cost.  High-reliability organizations operate at a very high risk which is controlled by the organization. The level of control always determines the cost of the risk. When the risk is effectively harnessed, the payer cost goes down since the instances of fatal incidences that may require compensations reduces (Chassin& Loeb, 2013). Nevertheless, in a situation where the organization is unable to arrest a situation, there is a high chance that the risk incurred will be very costly to any insurance firm. In this regard, it is very important for the payer to know the measure employed to mitigate the obvious risks and how effective these measures are in preventing avoidable harm.

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