Preview Edition / Fall 2004
PATIENT SAFETY INSIGHTS
Reliability is a key measure of success
As national attention focuses with increasing intensity on the safety of patients, a variety of patient safety related initiatives such as regulatory requirements, error reporting systems and technology are finding new prominence. In this journey, however, it is important not to lose sight of the ultimate destination. That destination is reliable health care.
Reliability is the measurable capability of a process or procedure to perform its intended function in the required time under commonly and uncommonly occurring conditions (1). High reliability organizations are those that, even with highly complex and dangerous activities, have very few errors. Examples of high reliability organizations include nuclear power plants, aircraft carriers and air traffic control systems. High reliability organizations exhibit harmony, balance and a sense of purpose with all aspects of the given process or product to produce a reliable result.
Health care is even more complex than the examples listed above. An aircraft carrier focuses on landing one aircraft at a time. Manufacturers are able to standardize parts and processes on the assembly line. In contrast, health care practitioners manage the arrivals, transfers and departures of highly individual patients with very different needs on any given day. When the individual practitioner practice, process and products are factored into patient needs, the result is fantastically complex care. The challenge for all health care professionals is to convert health care organizations into high reliability organizations.
MORE INSIGHTS
JUST CULTURE: Striking a balance between education and accountability
DATA MEASUREMENT AND PRESENTATION: Visual, verbal modes combine to clarify message
CLINICAL SAFETY: Wrong site, wrong procedure, wrong person surgery tips and tools
RESEARCH: Keeping up with the latest thinking
RISK IDENTIFICATION/ANALYSIS: Resources support risk management programs
