Becker's Hospital Review

March 2018 Hospital Review

Issue link: https://beckershealthcare.uberflip.com/i/949902

Contents of this Issue

Navigation

Page 84 of 99

85 FINANCE CMO / CARE DELIVERY Nuclear Energy… and Healthcare? What Health Systems Can Learn About Patient Safety From Other High-Risk Industries By Mackenzie Bean T he nuclear and healthcare industries share much in common. Both operate in high-risk environments and place great priority on workplace safety. However, the concept of zero harm — oen considered an unwavering standard in other high-risk industries, like nuclear energy — remains difficult to achieve in the healthcare arena. As health systems seek to improve workplace safety, they should look to strategies high reliability organizations use to foster safe working conditions in high-risk industries. e Agency for Healthcare Re- search and Quality defines high reliability organizations as those "that operate in complex, high-hazard domains for extended periods with- out serious accidents or catastrophic failures." By borrowing certain governance structures from these high reliabil- ity organizations, health systems can embed a more robust safety cul- ture into their own facilities, according to Gary Yates, MD, a partner in Press Ganey's strategic consulting group and an expert in safety and high reliability science. "Leaders, clinicians and support staff want to deliver excellent care to every patient," he says. "High reliability organizations outside of healthcare have shown us that getting culture right is an important piece of that puzzle." Dr. Yates has nearly two decades of clinical and leadership experience pertaining to quality improvement. He most recently served as vice president and CMO of Norfolk, Va.-based Sentara Healthcare and president of Sentara Quality Care Network. Dr. Yates also acted as president of the consulting firm Healthcare Performance Improve- ment, which Press Ganey acquired in 2015. Becker's Hospital Review spoke with Dr. Yates about high reliability in healthcare and how health systems can use this concept to improve their own patient safety culture. Editor's note: Responses have been lightly edited for length and clarity. Question: How has your clinical experience shaped your views on patient safety? Dr. Gary Yates: I learned a number of key lessons during my time helping lead quality and patient safety efforts as a health system lead- er. Back in the 2002-03 time frame, several of us were concerned we weren't making sufficient progress in patient safety. It seemed slow and siloed. So we began to look outside of healthcare for models to improve patient safety. We started to thoughtfully introduce concepts from high reliability organizations into the healthcare environment and saw some progress we hadn't seen before. We learned that to be successful, it's important to take a strategic approach to improving safety and reliability. Tactics to improve safety implemented in the absence of a comprehensive strategy are likely to have only limited success and are unlikely to be sustained over time. Second, creating a ro- bust culture of safety is essential to making significant progress in reduc- ing harm. And third, alignment between the board, senior operational leaders and clinical leaders is critical to successfully drive the kind of cul- ture transformation needed in a journey to high reliability. Q: Why is the concept of zero harm a targeted goal in healthcare, but a strict principle in other industries? GY: Focusing on zero harm really is fundamental. is focus leads us to take the necessary actions and adopt the strategies that will ef- fectively move us forward. Other industries have longer experience trying to create ultrasafe performance, and hopefully in healthcare, we can learn from them so we can improve safety faster and more efficiently than they did. Q: What principles can healthcare leaders take from these other industries to improve patient safety? GY: Although authors have described what makes other high reli- ability organizations highly reliable, no one has written the "how-to manual." So that's why it's important to thoughtfully look at how we can adapt some of those strategies. Karl Weick and Kathleen Sutcliffe, some of the most widely read authors on the topic, identified sever- al characteristics of high reliability organizations. One characteristic is "mindfulness," which consists of being preoccupied with failure or constantly looking for minor deviations that could turn into major problems if le unchecked. Another characteristic is sensitivity to an organization's operations. As leaders, we need to be very focused on what's going on at the frontline to get ahead of small problems before they turn into a significant harm for patients. Q: What is a common mistake hospitals make when trying to implement new patient safety initiatives? GY: One challenge is when hospitals or health systems implement new tactics without having them formally embedded in an overall strategy. It's important to get alignment in an organization by explaining the "why" behind the implementation of a new technique, tool or tactic. In some cases, hospitals and health systems haven't spent as much time on the why to make sure it is well understood. Aligning medical staff, administrative staff and others around what the change is and being sure it's embedded in a clear strategy everyone understands is important. Unfortunately, tactics implemented without that sort of alignment won't be as effective or sustained for as long as hoped. Q: What role does technology play in patient safety? How can hospitals harness new technologies to improve care "As leaders, we need to be very focused on what's going on at the frontline to get ahead of small problems before they turn into a significant harm for patients." — Dr. Gary Yates, Partner, Press Ganey

Articles in this issue

view archives of Becker's Hospital Review - March 2018 Hospital Review