HIGH RELIABILITY

The All Inclusive Guide to Healthcare's First High Reliability Solution--What It Is and How It Improves Your Hospital 

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What is High Reliability in healthcare?

High reliability in healthcare is the perpetual improvement of all processes in an attempt to offer the safest patient care possible.

High reliability is a strategic approach to improving and updating the technology, processes, knowledge, and reporting that empower staff in all departments.

Essentially, we are unintentionally falling short of providing every patient the safest care. How do we rectify this?  By streamlining current processes, and following those processes each and every time, we can significantly reduce the chances of harm.

Gone are the days of paper checklists and data entry that is never seen again. It’s time to replace outdated processes with tools that do the heavy lifting for us.

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Nurses spend, on average, 7.3 hours a week on non-essential paperwork, taking time away from patient care. [i]

"The impact of digital rounding has changed the culture of the hospital. The nurse manager is empowered to make decisions, resolve issues quickly and on the spot." [ii]

"Many healthcare leaders have a genuine interest in high reliability but often do not know how to incorporate it among their organization’s other priorities." [iii]
1. What are the Components of High Reliability in Healthcare and Why Does the Success of Your Hospital Depend on It?

Today’s healthcare has drastically changed. The old paper-based processes and manual data entry aren’t providing our patients with the best possible care.

If you want to become a safer, more reliable health care provider: introduce high reliability processes coupled with the human element of exceptional care in your organization.

“Patient safety has always been of top concern in the healthcare industry, but we have yet to produce measurable improvements as a whole.”

Technology has significantly changed the way we are able to provide care to our patients, and that means hospitals and clinics need to adapt their processes to meet those expectations.

“The truth is that most hospitals don’t know HOW to create digital processes on a system-wide scale.”

Let’s take a quick look at what is needed to create a reliable healthcare environment.

The Four Main Components of High Reliability in Healthcare

High reliability is an absolute must in healthcare today. Providing safer care is about utilizing technology to perform the same processes as before, but with more efficient and safer outcomes.

“Healthcare workers and staff are committed to providing exceptional care, give them the tools to succeed, and your hospital automatically becomes safer and more reliable.”

The human elements:

1. Teamwork

Teamwork in healthcare has long been touted as an essential component to delivering good health care to patients. It has been proven that teamwork reduces medical errors and increases patient safety.[i]

Much has been written about teamwork in healthcare, so we’ll just leave you with a few resources should you wish to investigate the topic further: AHRQ’s TeamSTEPPS, Patient Safety Network, FierceHealthcare.

2. A culture of safety

The concept of high reliability is the acknowledgment and thus commitment to safety among everyone in the organization—from staff to executives—this is where the term “culture of safety” originates.

A culture of safety in healthcare requires a few distinct aspects: 1) understanding the high-risk nature and committing to consistently safe operations, 2) the endorsement of reporting of errors without worry of reprimand, 3) collaboration among typically silo-ed departments to find innovative solutions to safety problems and 4) an ongoing organizational commitment to allocating resources for safety improvements.[ii]

Like teamwork, a culture of safety in healthcare is a well-documented subject; here are a few resources to get you started: Patient Safety Network, IHI’s What is a Culture of Safety?, IHI’s Develop a Culture of Safety.

The technology elements:

3. Electronic Health Record (EHR)

The electronic health record is the digital version of a patient’s medical history, with the ultimate goal of providing better care.[iii] This was the first major technological improvement towards automating and streamlining better patient care. Now that the industry has a well-established relationship with this technology, it is time to take the next major technological step towards becoming high reliability organizations: performance improvement.

 

4. Performance Improvement

The ultimate goal of performance improvement is the corresponding reduction in medical errors.[iv] Hospitals are best intentioned with their improvement efforts, but ever wonder why it’s so difficult to achieve significant, sustainable change? The answer lies in the lack of priority for purposeful, system-wide improvement. One-off PI projects can and do help for one issue in one unit for a finite period of time. The concept of sustainable performance improvement as a whole must rely on a system-wide scale, organizationally prioritized as a permanent goal and the resources needed to accomplish such a large undertaking.

We’ve seen hospitals struggle to implement PI initiatives from scratch, with limited internal expertise. To get the help you need with your performance improvement goals, you should partner with a PI solution-oriented company that understands the complexities of highly reliable healthcare organizations.

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2. Benefits of Partnering with a Performance Improvement Company That Understands High Reliability in Healthcare

Overhauling your organization to focus on system-wide performance improvement rather than incremental, unsuccessful attempts at PI is a smart choice. If done properly, it will allow you to sustainably improve processes across all areas and departments. But implementing a system-wide PI program can also take a toll on your already saturated management team and resources.

You spend so much time and money on your improvement and safety strategies that it’s hard to step back and realize it may not be making the impact you desire.

By partnering with a company that can provide the tools and knowledge you need to make big, lasting improvements you will very quickly optimize ROI.

Here’s how you’ll benefit from such a partnership.

1. Eliminate the Learning Curve of Healthcare PI

We see so many hospitals trying to reinvent the wheel when it comes to performance improvement. But why waste scarce resources when we’ve already done the hard work for you. We’ve spent the last ten years working one-on-one with clients, coaching them through performance improvement initiatives in clinical settings, environmental health settings, with infection prevention programs, and patient experience initiatives.

Creating and implementing a performance improvement or high reliability strategy can be a bumpy road. You’re not yet familiar with what works, what doesn’t work, do’s and don’ts. When you partner with a PI company, you’ll get the help you need to ensure your agreed-upon strategy is working effectively. This is an on-going relationship, ensuring your success well into the five-year mark.

2. Take Advantage of Having a Dedicated Person on the GroundWhite Plains Hospital Case Study

Partnering with a dedicated PI agency that specifically provides in-person full-time implementation will ensure the on-going success of the strategy. Your frontline staff might push back against the change. They may feel they are being replaced, or they may feel you are adding to their workload.

An agency that offers a dedicated PI partnership can make the transition smoother for your staff. Your dedicated implementation specialist will be able to coach your staff on the ways changing processes will be beneficial for them and their patients—that they won’t have to perform double-entry on rounding or chase down service departments for follow-ups, that they’ll actually be freed up to focus more on their patients while providing safer care.

“An agency that offers a dedicated PI partnership can make the transition smoother for your staff.”

Having someone who is familiar with the tools and has the experience and knowledge of PI in the industry propels your initiatives to the next level. Performance improvement relies on the management of many processes, across departments, on an ongoing basis. Instead of relying on multiple staff, managers or executives to divide their time between their actual job roles with the implementation of a facility-wide program, a full-time partner will be dedicated to your success.

3. Leverage the Knowledge of Regulatory Masters

Some performance improvement solutions in healthcare are off-the-shelf softwares that lack customization for your specific regulatory needs and rely on your IT department to implement. Other performance improvement solutions tackle only a few certain aspects of high reliability, but leave out regulatory standards altogether leaving the rest for you to figure out. And some industry tools are made by the very regulatory agencies that are surveying you, which is only focusing on a narrow piece of a much larger patient safety performance improvement issue.

Partnering with a performance improvement agency that designed their solution around many of the industry’s top regulatory agencies’ standards is like having a life raft onboard. The regulatory healthcare expertise of an on-site PI agency bridges the gap often experienced with off-the-shelf solutions.

Why the Success of Your Hospital Depends on a High Reliability Partner

As discussed, high reliability in healthcare requires teamwork, a culture of safety, use of the EHR and the commitment to a performance improvement program. Implementing a hospital-wide performance improvement solution is a drastic change. It can be hard to get all of your staff from all departments on board. If you’ve recently implemented some safety improvement initiatives and your staff is having trouble adhering to the new process or struggling to sustain the process over time, or your PI team simply can’t decide on a strategy, then working with a high reliability company that offers a performance improvement partnership is critical.

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3. What Do You Gain by Embracing High Reliability?

Is it decreasing Hospital Acquired Infections? Is it increasing HCAHPS scores? Is it streamlining outdated processes? Is it freeing up more of your time to care for patients?

Safety in healthcare has always been a priority, but it’s time to make some swift changes in order to accomplish the goals we’ve been after but never quite achieved. With the rise of technology, the healthcare landscape has an untapped limitless potential—you must equip your staff with the right tools to thrive in the new era of healthcare.

Here’s a short breakdown of only a few of the myriad ways high reliability will benefit your hospital.

Streamline Your Operations

Conducting rounds on paper is inefficient. Building spreadsheets from scratch to house rounding data is a time sink. Data entry of paper documents is a significant detraction from spending time with your patients. Scheduling complex calendars to coordinate rounds is at best inefficient, but worse rarely effective. The automation of data: collecting, recording, analyzing, and coordinating improves the way staff uses their time. They are able to use that time to prioritize patient care instead of on time-consuming administrative activities and searching for disorganized information in many different locations.

Implement Improvement Initiatives That Are Effective

When data is digitally gathered and corralled into one database, the ROI magnifies many times over. Why? First, the collection processes are now streamlined, but more so there now exists data that can be analyzed—this is the obvious, yet revolutionary aspect of improvement. A typical hospital makes well over 400,000 quality observations (data points). But because they are made in many different formats, there currently exists no means to aggregate, distribute, or analyze it. Without data change is improbable, with data we are able to analyze and report on trends that lead to improvement initiatives. This is where performance improvement is born. Your PI team can make data-based decisions to prioritize improvement initiatives, watch their progress, and use as resources for on-site regulatory surveys.

“The days of guessing on or arguing about which safety errors need improvement and their priority are over.”

Improve Your Quality of Care

Now that you’ve gleaned insight from real data, and have taken thoughtful action on areas of actual concern, improvement happens. If a certain improvement initiative is not working, you will know because you will have the data, and you can adjust or reassess processes to meet your ultimate improvement goal. It is important to point out that none of this is possible without meaningful data aggregated into intuitive reports.

With a performance improvement partner that supplies the heavy yet agile data aggregation, medical errors will become data points that will drive improvement initiatives. Focusing in on the top medical errors being reported and build effective improvement campaigns. Find out which environmental factors are being reported as the least desirable for patients and drive improvement on those.

Quality of care you provide now has a fighting chance for constant, sustainable improvements. Regulatory surveys will be painless because you will have already been completing accurate processes and showing improvement progress. High reliability becomes attainable when issue after issue is found, acted upon, and always in an improvement process.

Still not convinced? Let's look at a recent case study.

Case Study: White Plains Hospital Pioneers High Reliability Methodology

With a dedicated onsite director, White Plains Hospital, one of the highest performing systems in the state of New York, has begun streamlining existing processes by consolidating a wide variety of applications into a single platform. Additionally, they are gaining transparency so that staff and management at all levels have access to and can act upon improvement efforts.

Readiness Rounds provides a full-time onsite High Reliability Director who supports White Plains Hospital in developing, deploying, and sustaining all aspects of the platform. The consistent preoccupation on performance improvement is the cornerstone of this high reliability solution. The solution guarantees the improvement of six major hospital outcomes over a five-year period. 

Read the full case study here:

White Plains Hospital Case Study

4. Which High Reliability/PI Tools Should You Invest In?

For your staff to succeed in the future of healthcare, you must equip them with the right tools to provide safe and efficient care.

That’s where performance improvement tools come in.

"Performance Improvement tools will give your staff a fighting chance to provide the highest quality care at an efficient and effective rate for your hospital."

Performance Improvement tools can do the following for your hospital:
  • Save time
  • Allow for continuous improvement
  • Add value to the patient
  • Align all the departments with the goals of the hospital
  • Collect, analyze and report meaningful data

Arguably the best high reliability performance improvement platform in the digital healthcare industry, Readiness Rounds is a must-have PI tool for hospitals and hospital systems.

Among the many benefits, these three key aspects of the Readiness Rounds tools will help your team succeed:

Digital Data Collection for Streamlined Rounding

Your staff is going to love Readiness Rounds app. This digital tool eliminates the tedious manual work that disrupts patient care and wastes everyone’s time. The Readiness Rounds process will actually save time. Stop wasting valuable time and resources on manual rounding and spreadsheet management. Readiness Rounds app is easy to implement and use, works in the background with your existing digital platforms, and allows your staff to stay focused on patients. Use it in all departments, at all levels of the organization, and even capture data from other sources.

Data Aggregation and Reporting for PI

Did you know a typical hospital makes well over 400,000 quality observations annually, in many different formats (at least 20) with no means to consistently aggregate, distribute, analyze, act or drive performance improvement?

As is the case in most hospitals, data is collected and stored in an abundance of disparate sources. Readiness Rounds is robust enough to round up, store, aggregate and report all non-EHR data into a single platform. Simply put, this allows staff and managers, at all levels, real time access to reliable, consistent data to prioritize performance improvement efforts.

The ability to employ this approach means monitoring ongoing results with minimal effortunleashing the power of the Readiness Rounds platform. This eliminates the constant reaction to the issue of the day, allowing staff at all levels to easily watch and be aware of quality issues as they develop. This early identification of issues, on a systemic-level, promotes the proactive nature of successful performance improvement. 

Regulatory Compliance for Survey Readiness

The ability to consistently meet and exceed core regulatory requirements of The Joint Commission, CMS, and state requirements and more is an essential aspect of hospital operations. Adopting a high reliability model incorporates ongoing compliance. Thereby, over time, regulatory compliance becomes a byproduct of high reliability. 

With a major volume of quality observations tied to The Joint Commission's Standards and Elements of Performance and CMS Conditions of Participation, leadership has immediate access to results at their fingertips. This allows for real time documentation of proactive rounding, processes, and results to regulators during survey time.

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Conclusion

 

With the way today’s health care industry is changing, there’s no denying the need for high reliability tools. The most successful hospitals know how vital high reliability is to increased patient safety and experience, and long-term financial stability. 

Statistics are now proving what we’ve known for a long time: Online reviews play a significant role in patient acquisition and retention. The rapid proliferation of social sharing and consumer reviews has transformed the way patients select providers.” [i]

When you empower your staff, you enhance the quality of care and experience they are able to provide.

And when you partner with a high reliability company that understands health care PI, you’ll get the help you need to implement a successful strategy and empower your entire team.

So what are you waiting for? Get started with high reliability.