Fields & Associates, Inc. (F&A)

J*_LD03_High Reliability Organizations

Resources: High Reliability In Health Care Organizations

Relevant Standards

  • CMS: §482.21 Condition of Participation: Quality Assessment and Performance Improvement
    Program  (A-0265, A-0275, A-0276-7, A-0286, A-0291, A-0310, A-0311, A-0312)
  • TJC: LD.03.01.01, LD.03.05.01

References & Tools

Required Written Documents

  • None

** Additional Clarifications & Compliance Strategies (Premier)**

[private Membership premier]

 

[/private]

• Stages of Maturity in Health Care Organizations’ Path to High Reliability,[®] The Source, August 2011, Volume 9, Issue 8 [PEARL: LDR, GB]
Reading Tips Review – Aug  2011, Vol 5, #8:

In April and May of this year, TJC began using an article by Drs. Chassisn and Loeb entitled, “The Ongoing Quality Improvement Journey: Next Stop, High Reliability (PDF)1108” to encourage the healthcare field towards the concept of ‘High-Reliability’. In our review of the article, The Joint Commission Urges Health Care Organizations to Focus on Achieving High Reliability (Perspectives, May Vol31, #5 pg 3), we noted TJC’s recommendation that organizations assess themselves on readiness for being/becoming a high-reliability organization. This article
provides a self assessment grid for rating your facility’s stage of maturity in the three factors considered critical for high-reliability: 1 – leadership making high reliability a priority; 2 – creating a culture of safety and 3 – utilizing proven quality improvement methods such as Lean Six Sigma and change management (aka Robust Process Improvement). Even if ‘High-Reliability’ is not on your radar, leaders would benefit from taking a couple of minutes to peruse the chart for the insight and impetus it might provide… on the future of healthcare???

 

The Joint Commission Urges Health Care Organizations to Focus on Achieving High Reliability Perspectives, May 2011, Vol 31, #5, Pg03 – FYI: JCSC, LDR,
Reading Tips Review – May 2011, Vol 5, #5:

The urging is done in an article by Drs Chassin and Loeb, entitled, The Ongoing Quality Improvement Journey: Next Stop, High Reliability and it is available for free download. The authors call for something they admit has never been achieved; consistent performance by healthcare organizations at high levels of safety over long periods of time or “high reliability”. The key to achieving this ambitious goal is in leadership making high reliability a priority; creating a culture of safety and utilizing proven quality improvement methods such as Lean Six Sigma and change management (aka Robust Process Improvement). The authors also urge TJC hospitals to self assess these areas. As we indicated last month in our first review of this article, we believe this is an important evolving concept and direction for TJC.  See also Drs. Chassin/Loeb article focuses on high reliability and health care (JC Online 4/6/11)[®]

JCO 4/6/11
Health Affairs article written by Drs. Chassin and Loeb publishes tomorrow, focuses on high reliability and health care [ALERT: PI, LDR, GB]
The concept of safety and performance improvement within TJC continues to evolve as indicated by the
comments of TJC leadership in this recent article. Here the focus is on consistent performance by
healthcare organizations at high levels of safety over long periods of time… or “high reliability”. The
article lists the three requirements for achieving high reliability as Leadership Commitment, having a
Safety Culture and utilizing Robust Process Improvement. All three have been points of emphasis by
TJC in recent years. The full article, The Ongoing Quality Improvement Journey: Next Stop, High
Reliability , is available for free download. This is another indicator of TJC philosophical direction that
LDR, GB and PI would be wise to be more aware of.

 

• Making Health Care a High-Reliability Industry: The Joint Commission Launches Center for Transforming Healthcare [®]  Patient Safety, November 2009, Volume 9, Issue 11, Pg 10 FYI: JCSC, PI, IC, RN. 
Reading Tips Review – Nov 2009, Vol 3, #11:

TJC’s new Center for Transforming Healthcare began in September of 2009. TJC says “The center brings together the leading hospitals and health systems in the United States to identify specific underlying causes to patient safety problems and develop targeted solutions to solve those problems, and then share those solutions with health care organizations nationwide.” Essentially, its mission is to reduce the occurrence of key
preventable errors in healthcare. [PEARL] To that end they will be employing a process utilizing tools and methods from Lean Six Sigma called Robust Process Improvement. LDR and PI should increase awareness of these approaches as TJC announced last year its intent to adopt this new change strategy. These approaches are thought to be more effective than PI/QI in producing and maintaining excellence, particularly in challenging, improvement-resistant work processes. The Center’s first project addressing hand hygiene and HAIs has already begun to identify important causal factors and recommended solutions. One of its next projects will target patient handoffs with a report expected in December 2010. A word to the wise. The article says you may expect to hear and see more about the findings/recommendations from the centers projects on TJC’s intranet and even as a part of surveyor process. For more on RPI and TJC see: Sustaining the Improvement We Need by Mark R. Chassin, MD (11/6/08) [especially slides 16-21] [HTML] (PDF) For more info on Lean, Six Sigma and Lean Six Sigma goto our SL1 library page on PI & Data Management Tools

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