High Reliability Organization

The Highly Reliable Hospital of the Near Future

How do we achieve high reliability in our hospitals, and what is currently holding us back?

High reliability hospital blog header


The Back Story

A few blog posts ago, my colleague and infographic virtuoso, high reliablity infographic preview image put together a wonderful infographic showing how the Readiness Rounds software platform fits in with hospitals that are actively moving towards High Reliability.

See the 4 High Reliability Musts in Healthcare infographic here.

The feedback on this infographic has been great and it is apparent a lot of our readers and/or their hospitals are interested and, at the very least, saying they want to get to High Reliability/Zero Harm.  

So, while that infographic connected the dots for some, I wanted to take an opportunity to explain further how the Readiness Rounds platform fits into the Hospital High Reliability puzzle.

Over the last several years of development, the Readiness Rounds software has grown from primarily a hospital accreditation tool to a full-blown patient safety, quality of care and patient experience software platform, specifically designed with High Reliability for hospitals in mind. The only one of its kind.

While the basis for the platform is a comprehensive rounding, checklist, quality data collection tool, the additional value from a closed-loop follow-up system, reporting features, built-in performance improvement prioritization, linkage to regulatory standards (TJC, CMS, etc.) and even an Event and Incident Reporting module make the platform a true High Reliability tool for the hospital wanting to do more than just talk about High Reliability and actually work to get there.

 high reliability and zero harm

So what’s missing?

As you saw from the aforementioned infographic, a High Reliability hospital must establish four different milestones: a radical commitment to teamwork, a patient safety culture, meaningful use of an Electronic Health Record and the conscientious use of a Performance Improvement Platform (like Readiness Rounds).

While most hospitals have utilized an EHR, less have developed a true patient safety culture, even less have developed the radical commitment to teamwork and very few have adopted a High Reliability process improvement platform hospital wide. 

High reliability | readiness rounds platform

What do these four High Reliability approaches mean exactly?

1) A radical commitment to teamwork

high reliability hospital

The traditional social structure of health care organizations is extremely hierarchical, with physicians at the top of the food chain and everyone else arrayed below them. In the past, hospitals that emphasized teamwork as a goal did so without changing the underlying attitudes of the hierarchical system. As a result, employees were often hesitant to question a superior’s decision or even to make a suggestion for fear of scorn, humiliation, or even retribution from the higher-ranking person.

In order to achieve High Reliability, health care organizations must commit to a kind of teamwork that erases the old hierarchical structures completely. In an HRO, the success of the whole depends on the input of every individual. Each employee’s experience merits respect and each employee must feel able to make suggestions with confidence, knowing that his or her input will be taken seriously. 

Ask yourself, can or will a nurse at your hospital tell a senior physician they just did something contrary to protocol? 

2) Patient Safety Culture

A truly High Reliability health care organization must hold patient safety as its highest goal, uncompromised by other concerns.

All employees must understand that the fundamental purpose of their jobs, whether they are surgeons, administrators, or maintenance workers, is to provide the safest environment possible for every patient.

This is not to say that health care HROs should not be profitable (they should), or that they should neglect other areas of operations, but rather that Patient Safety should be the baseline from which all other activities arise.


3) Meaningful use of Electronic Health Record

I don’t need to say much here, as we mostly all know the objectives of EHRs are to improve quality, safety, efficiency, and reduce health disparities.


4) Consciences use of a performance improvement platform

The most commonly missing attribute.

In order to become an HRO, an organization must have the capability of handling multiple complex and complicated procedures and processes across all of its widely diverse departments.

It must be able to establish and track essential protocols and to meet and adapt to changes in best practice requirements as established by all regulatory agencies.

Clearly, these tasks are beyond the abilities of any one person or even a department.

In order to function effectively in today’s complex and ever-changing regulatory and technological environment, health care organizations must acquire and make proactive, regularly scheduled and sustained use of a software platform that provides real-time regulatory updates, monitors checklist compliance, and generates accurate metrics for use in determining future process improvements.   

high reliability | readiness rounds

In Closing

While these may seem evident to those familiar with a quest for HRO status in health care, they represent a significant re-imagining of how health care works.

Traditionally structured health care providers face significant changes in how they think and function if they are to merit High Reliability ranking, but if these four attributes are achieved, the day-to-day process of improvement becomes feasible.

It is critical for the hospital wanting to reach High Reliability/Zero Harm to be able to measure, continually improve and sustain performance. If you agree, contact us here to schedule a free consultation.



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