High Reliability Organizations

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High-reliability organizations (HROs) are a significant part of the healthcare industry nowadays. Researchers define high reliability as “the ability of a complex organization delivering high-risk services to achieve and sustain extremely low rates of harm over time” (as cited in Polonsky, 2019, p. 214). Several vital characteristics allow HROs within the healthcare industry to strive for patient safety, with zero harm. Those characteristics are “preoccupation with failure, reluctance to simplify observations, commitment to resilience, and deference to expertise” (Polonsky, 2019, p. 214). Along with other improvement frameworks, high reliability significantly contributes to the medical field, appearing as a model with various tools to support HROs’ intentions.

However, the high-reliability framework has been undergoing crucial changes in the past 30 years. Researchers claim that the healthcare industry representatives started active adoption of the high-reliability mindset at the end of the 20th century. Several critical events happened then, such as Chernobyl nuclear disaster and numerous catastrophes in the aviation industry, significantly increasing the priority of safety (Polonsky, 2019). The great shift of the paradigm for HROs occurred later, at the beginning of the 21st century. Statistics indicate that more than a quarter of a million individuals die every year in the United States due to miscellaneous medical errors (Polonsky, 2019). The data illustrated a dire necessity for improvement, and embracing the HRO framework was the most profitable way to accomplish it. Thus, investigators, scientists, and clinicians initiated revving advances in patient safety, executing the HRO model (Oster & Braaten, 2016). In order to determine its weaknesses and strengths, each organization can conduct a performance evaluation according to the survey.

Organizational Domain Least Mature 2 3 Fully Mature
Leadership
Aspects
Doctors seldom conduct quality advancement shiftings; general
participation by medics in these movements is downward.
Physicians support some grade advancement moves; doctors experience these shiftings seldom but not widely. Physicians frequently conduct quality modification activities; physicians are engaged in many spheres, but a few critical gaps remain. Doctors constantly conduct clinical rate advancement measures and tolerate the supervision of other clinicians; medics’ involvement in these shiftings is livery throughout the institution.
Safety Issues No criteria of safeness culture are present. Some standards of protection cultures are present but are not overall or not applied for improvements. Measures are embraced and operated through the institution; actions to enhance safety culture are at the initial stage. Safety culture criteria are conveyed to the administration; advancement initiatives and measures are underway to perform security culture comprehensively.
Robust
Process
Improvement
No legal procedure for quality administration has been implemented. Investigation of current approach modification instruments starts Commitment to implement all modern advancement means has been made. Adoption of modern modernization tools is implemented.
Robust
Process
Improvement
There is an absence of commitment to the overall comprehension of enhanced techniques. Pilot schemes utilizing several new mechanisms are performed in a few spots. RPI is employed to enhance industry processes, clinical grade, and safety; a favorable return on assets is performed. Constant usage of RPI instruments for all modifications; patients are committed to redesigning maintenance procedures, and RPI mastery is demanded for further promotion.

Figure 1: HRO Evaluation Maturity Survey

It will contribute to the improvement as it provides an opportunity to assess the key elements necessary for the existence of HRO. First of all, it measures the possibility of risk and harm prevention in the initial stages (Figure 1). It enables the comprehension of engaged employees and leaders level. The survey will help identify weaknesses in collective transmission and understand the focus areas to reduce errors. Moreover, in recent times, failure has become the reason for a lack of accountability (Oster & Braaten, 2016). Surveys main limitations are the possibility of giving false answers, which will lead to a misinterpretation of the actual results. Equally important is the support of management, which directly influences the implementation of the survey and HRO in general. Correspondingly, to check the reliability of the study and its correlation with the actual clinical practice, it is necessary to carry out other research.

References

Oster, C., & Braaten, J. (Eds.). (2016). High reliability organizations: A healthcare handbook for patient safety & quality. Sigma Theta Tau International, Honor Society of Nursing.

Polonsky, M. S. (2019). . Journal of Healthcare Management, 64(4), 213-221.

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