High Reliability in Health Care is Possible
High Reliability Health Care
Mark Chassin, MD, President and CEO, The Joint Commission
If not us, then who?
“As with any fundamental change in health care, the hard work of accelerating development of a safety culture begins with senior leadership. Without concerted and ongoing efforts by senior leaders to exemplify and cultivate that culture, the organization cannot change.”
Ana Pujols-McKee, MD, Chief Medical Officer, The Joint Commission
High Reliability Health Care Maturity Model
A Practical Framework for Improvement
High reliability means consistent excellence in quality and safety across all services maintained over long periods of time. This high level of performance, which includes the elimination of major quality failures, does not exist in health care today.
Based on its knowledge of health care and through studying the features of industries that have achieved high reliability, The Joint Commission constructed a framework that health care organizations can use to accelerate their progress toward the ultimate goal of zero harm. The framework is organized around three major domains of change:
- Leadership committed to the goal of zero harm.
- An organizational safety culture where all staff can speak up about things that would negatively impact the organization.
- An empowered work force that employs RPI tools to address the improvement opportunities they find and drive significant and lasting change.
Learn more about the Joint Commission’s high reliability model.
If not us, then who?
Commitment to zero harm is the first important step. Commitment becomes actionable when leaders ensure that their organization has the necessary resources and expertise to make zero harm possible.
The Center offers many programs that can help, from leadership change management training to online leadership self-assessments such as Oro® 2.0, that help you launch, promote, and support transformation to high reliability.
Trust is the foundation of a safety culture. Trust leads concerned employees to report unsafe events and identify opportunities for improvement. When leaders respond positively to these opportunities, employees are further motivated to report, which in turn results in more improvement and builds even greater levels of trust.
The Center will help you strengthen trust within your organization. These include programs that define acceptable behaviors and empower your employees to speak up about safety risks and report errors and near misses.
Robust Process Improvement
Safety problems in health care persist because they are complex. Unless we understand the true reasons why something isn’t working, we will constantly struggle to improve it.
Robust Process Improvement® (RPI®) helps you get to the root of the problem and discover the best solution.
Health care organizations need new process improvement tools and methods to address common safety failures and rare adverse events that harm patients and employees. RPI a combination of Lean Six Sigma, and change management is a much more potent set of tools than health care currently uses to address safety and quality problems.
- Lean is a set of tools and a philosophy of employee-empowered improvement that identifies and removes wasted effort from processes without compromising the quality of the outcome.
- Six Sigma tools focus on improving the outcomes of a process by radically reducing the frequency with which defective products or outcomes occur.
- Change management is a systematic approach, used alongside Lean and Six Sigma, that prepares an organization to accept, implement, and sustain the improved processes that result from the application of Lean and Six Sigma tools.
These three sets of tools are complementary and together they provide the best available methods for health care organizations to achieve major improvements in faulty processes.