As a leader in healthcare transformation for many years, I often wonder why the healthcare industry lags behind the aviation industry or the car manufacturing companies when it comes to strategies to becoming high-reliability organizations. These industries' drive to perfection and peak efficiency while maintaining safety is recognized worldwide by all other industries. They do it quite well that it makes me think of what's keeping us from becoming so, and what processes do we need to be like them.
These industries operate on a common ground of safety and customer care. They function at high efficiency and perform complex tasks to have an error-free service delivery. An error-free operation is important to them because they are aware that even simple mistakes can cost lives. In healthcare organizations, this paradigm is the essence of care delivery. It is the same principle that drives employees to perform in the same manner as these industries do in providing seamless service without causing undue harm to their clientele.
What kind of strategies, tools, and behaviors are needed to achieve a high-reliability status in healthcare? Here are five ways you can help your organization do so.
1. Maintain ‘situational awareness’
Maintaining situational awareness is like having a built-in alarm system within the organization that is triggered when signs and symptoms appear even before reaching critical points. The management and staff are constantly in the know-how of processes and workflows, and their interrelatedness to each other. The awareness reduces the possibility of committing errors, and it can rectify mistakes before results become catastrophic. This step saves company resources and more importantly, lives.
Employing a culture of transparency, which would foster two-way communication and data sharing achieves situational awareness, whether the data is about patient satisfaction or organizational performance.
Another way is to have a monitoring tool that is real-time, and that which can track task completion and workflows. Supervisors can do rounds at every workstation to convey leadership presence and some personal involvement at the work base.
2. Be preoccupied with failure.
Being preoccupied with failure far from dwelling on the negative. It only means that the organization can predict the areas where errors would most likely arise. It is not reacting to a failure, but rather anticipating possible sources of it even before it can cause harm. They look at ‘near misses' and make evaluations of such incidents to prevent similar occurrences in the future. Near misses are taken as opportunities to improve on a process, to find solutions to address potential dangers, and more importantly, to understand cause-and-effect data. It is like patching a crack on a boat before the damage becomes big enough to become a hole that could sink the vessel the moment it sails.
3. Simplify processes and delivery of information, but never simplify explanations.
Healthcare has complexities all around, from people to processes, to clients. Simplifying processes are highly beneficial, but simplifying explanations as to why processes are streamlined have the opposite effect. Does this mean providing overwhelmingly complex information to your staff? No. Putting it in the right perspective, it means having the right information delivered to the right people in real-time. For example, It is not necessary to send protocol update information to the OB-GYN department if the change concerns the medical staff only. But a change in organizational policies would need to be delivered to all employees regardless of designation or duty.
Another example is that of applying Lean concepts in healthcare. Lean is an attractive word to the management, but its meaning can be misconstrued as loss of tenure for people at the frontline of service. It is then important to provide the correct information in a timely and efficient manner so that leaders could drive initiatives with enough staff support.
4. Recognize expertise, and let the experts have the greatest say at change.
Experts need not necessarily be leaders or only those with all of the data on hand. Experts are also those with first-hand knowledge and experience of a process or task. If problems with coordination of care create challenges and bottlenecks, determine who handles the work. Are they the frontline workers? If they are, then they are the expert on the subject. Is the problem about transitions of care? Then probably, physicians and frontline alike would have the most say when streamlining workflows in this process area.
Deference to expertise does not end at recognizing who the experts are, and hearing what they have to say. The organization should also strive to have a culture that would accept such expertise, and consider their contributions to problem-solving as significant.
Leveling the hierarchy is very instrumental in making this happen. When face-to-face interaction to elicit expert input is time-consuming, then another platform should be utilized. Having a standard intranet hub where individual feedback can be made and accessed by management is a practical way to kick-start leveling the hierarchy.
5. Build resilience within your organization.
Mistakes happen. Even with the most accurate approaches and the strictest measures, failures still arise. In healthcare, medical errors are a major concern. In fact, it is the third leading cause of death. Incidences of medical errors are the most formidable challenges when developing high-reliability organizations in healthcare. Building resilience only means being able to contain the failure, triggering fail-safe mechanisms, and still being able to function with high degree of reliability even if one area or process becomes problematic. Think of this as being similar to roadblocks. There should be manpower, detours and rerouting schemes available so that traffic flows continuously without too much inconvenience to moving vehicles.
Are you looking for ways on how to drive your institution's high-reliability goals? If you are looking for a tool that can meet your organization's communication, collaboration, and monitoring needs, ManageUP can help. Contact us for more information.