Achieving High Reliability

The zero harm way

Prasanthi Sadhu, Editor, Asian Hospitals and Healthcare Management

 

“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.”

Mark Chassin, President and CEO of The Joint Commission.

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“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.”

Mark Chassin, President and CEO of The Joint Commission.

As the proverb goes ‘Prevention is better than cure’, organisations that focus on zero harm rather than trying to minimise risk after an incident are deemed ‘highly reliable’. Industries such as aviation and nuclear power succeed in preventing harm by implementing safety systems with the concept of collective mindfulness and pursuing a zero-defect environment. Healthcare industry is no different as the risk here is with health and lives of people, be it patients or staff. With increasing patient expectations, advancements in technology, achieving zero harm is the key for healthcare industry and organisations alike as delivering effective care continues to be a challenge.

Medical errors cost lives of millions all over the world; the data from American Hospital Association (AHA) indicatesmedical errors lead to four times more deaths than motor accidents. Whether it is lack of communication about potential health risks or absence of quality care providers, the result could be loss of lives.

In order to attain zero harm in their industry, health leaders have to prepare themselves for supporting high reliability by committing and focusing on providing quality care and safety for every patient, every time. The onus lies on the leaders to trust their teams to deliver quality healthcare with high levels of patient safety. The entire team has to work on the same measure with a common goal and vision.

The frontline workers need to find the errors and unsafe conditions and report them to their leaders for consistent adherence to safe practices. The leaders, in turn, have to self-assess and reassess various areas for process improvements. This is done to anticipate or detect potential problems early and always respond to early enough to prevent catastrophic consequences.

An organisation is said to be High Reliability Organisation (HRO) only when it is in the next level in pursuit of quality and process improvements. The Joint Commission (JCI) suggests that hospitals and healthcare organisations create a strong foundation as they embark on the transformation journey to be an HRO. The JCI coined the term ‘robust process improvement’ to encapsulate an approach that includes Lean Six Sigma and change management philosophies, methodologies and tools. Applying HRO concepts does not require a huge campaign or a major resource investment. It begins with leaders at all levels acknowledging the need to provide better care and prevent medical errors that cost lives and most importantly establishing a culture of safety for patients and healthcare staff both.

Regulators need to incorporate HRO theory into new or updated regulations. This could help propagate the theory throughout the industry for reducing patient harm. This would reduce the estimated US$38 billion (Debourgh & Prion, 2012) spent on addressing safety incidents, and improve the quality of life for patients. The cover story of this issue by Sangita Reddy, Jt. Managing Director of Apollo Hospitals delves into the aspect of Zero Harm in healthcare industry.

Author Bio

Prasanthi Sadhu

Prasanthi Sadhu Editor, Asian Hospitals and Healthcare Management