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HCPro

Zero harm is the goal


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Ask 10 healthcare leaders if they’ve heard of high reliability, and it’s almost certain all 10 will say they have. Ask those same 10 to define high reliability, and things get interesting.

Many healthcare leaders have a genuine interest in high reliability but often do not know exactly what it means or how to incorporate it among their organization’s other priorities. They just know it sounds right to say their organization is working to “get to high reliability,” and they hope it will be the silver bullet that solves all problems. Unfortunately, the term “high reliability” can become a buzzword when used without understanding what it is. Employed this way, it may sound great but lack substance—all sizzle and no steak.

The first thing true high-reliability organizations (HRO) acknowledge is how much they don’t know and how much there is to learn. A culture of learning and teaching is at the core of an HRO. Other complex, high-risk enterprises—such as the airline and nuclear power industries, as well as amusement parks—have adopted this concept and avoided catastrophic events for long periods of time.

In an HRO, everyone from the front lines to the boardroom takes responsibility for safety, which first and foremost requires trust. In a trusting organization, management and staff recognize that everyone across the organization has expertise and contributes to patient care. Peers hold each other accountable. Staff members feel comfortable reporting errors and variations in care to their supervisors. Everyone feels accountable for safety, which is really a relentless focus on improvement, and behaves accordingly.

(Editor’s Note: This article appears in the November/December issue of PSQH. Continue reading it here.)