Patient safety is among the chief concerns of healthcare practitioners and institutions. These parties strive to ensure that patients are provided with services that safeguard their wellbeing. However, despite their best efforts, many institutions still struggle to ensure patient safety (Chassin & Loeb, 2013). For example, every year, thousands of patients develop complications and die as a result of unsafe conditions in healthcare organizations. If these organizations are truly committed to enhancing patient safety and guaranteeing the wellbeing of their patients, they should look to high reliability organizations (HROs) for inspiration. Since they have defied expectations and succeeded in environments that are replete with hazards, the HROs are perfectly placed to guide healthcare organizations in their quest for enhanced patient safety.
The concept of HROs
The concept of HROs offers insights into the measures that healthcare providers can institute to minimize the hazards that patients are exposed to. Essentially, this concept describes firms and organizations which operate in high-risk environments but have managed to implement strategies that enable them to avert disaster (Christianson et al., 2011). Aircraft carriers and firefighting are some of the sectors that have successful employed the principle of HRO. Organizations in these sectors have defied expectation. Since they conduct their affairs in risky environments, one would expect that the organizations would report accidents. However, thanks to the safety measures that they have adopted, these organizations are able to insulate their practitioners against the hazards (Grabowski & Roberts, 2016). One of the key elements of HROs is preventive action (Christianson et al., 2011). Firms that have adopted this concept are able to predict problems and effect strategies that aim to either avert or minimize the impact of the problem.
Delegate your assignment to our experts and they will do the rest.
How HROs can transform healthcare
The airline industry is among the sectors that have successfully integrated HRO into their operations. The healthcare profession needs to follow the example of this industry. As it does this, the profession should expect to witness tremendous and unprecedented transformation. One of the changes that HRO will introduce involves enhanced patient safety. Poor patient safety record is among the challenges that taint the image of the healthcare profession (Chassin & Loeb, 2013). Many patients endure unnecessary hardships as a result of the failure of healthcare professionals to prioritize safety. As mentioned above, safety is the key focus of HRO. As they embrace HRO, healthcare organizations will be poised to witness improved patient safety. For example, the intensive care unit (ICU) is one of the areas where high risk resides. Through HRO, healthcare organizations can eliminate the hazards in this area, thereby improving patient safety.
The impacts of HRO on healthcare go beyond enhancing patient safety. The adoption of this principle also promises to significantly lower the costs that healthcare providers incur (“Transforming into a High”, n.d). Medical negligence is one of the sources of the costs that medical facilities incur. There are hundreds of cases where patients sue practitioners after they suffer following the failure of the practitioners to offer proper care. The HRO principle challenges organizations to predict and avert disaster. When they embrace this principle, practitioners will be able to predict the high cost of medical malpractice and negligence. Consequently, the medical facilities will record significant declines in the cost of operation.
In their article, Mira, Lorenzo and Navarro link patient safety to the reputation of a healthcare provider. They suggest that facilities with an excellent record of patient safety tend to enjoy positive images. They note that their results “suggested that the social reputation of these hospitals and the perceptions of patients or relatives of patient safety were indeed correlated” (Mira, Lorenzo & Navarro, 2014). The discussion above has established that upon the adoption of HRO, healthcare organizations will witness improvements in patient safety. Therefore, working with the findings that Mira and her colleagues present in their article, it follows that the integration of HRO will also result in an enhanced image for healthcare providers. The public will view these providers as truly committed to ensuring patient safety.
Reasons for lack of progress
From the discussion above, it is evident that healthcare providers stand to enjoy numerous benefits upon becoming HROs. This raises the question of why many healthcare providers have been unable to evolve into HROs. There are a number of barriers that are responsible for the lack of progress. Project fatigue is among these barriers (Chassin & Loeb, 2013). Essentially, project fatigue results when a medical provider faces too many challenges that overwhelm its capacities. Eventually, the provider simply decides to abandon all effort to enhance service delivery. Another barrier that hinders the transformation of medical facilities into HROs is the incompatibility of HROs and medical providers. In their article, Chassin and Loeb (2013) observe that “the ways that high-reliability organizations generate and maintain high levels of safety cannot be applied to today’s hospitals” (p. 459). This observation that Chassin and Loeb makes means that while HROs provide key lessons for healthcare providers, these lessons cannot be applied directly. It is therefore not surprising that many providers have made little progress in their quest to become HROs.
Many healthcare providers operate on shoe-string budgets. The needs of the providers overweigh the meager budgets. To become a HRO, a healthcare provider would need to implement a number of costly undertakings. For example, the provider may be required to purchase equipment or hire more staff. All these initiatives are costly. The high-cost of becoming a HRO is another impediment that hampers the efforts of medical facilities to become HROs. Poor structures and processes are another barrier to the adoption of the HRO model. Chassin and Loeb (2013) note that many hospitals fail to embrace the measures that HRO implement as they seek to promote efficiency and safety. These researchers essentially suggest that in their current form, hospitals and other facilities are simply not prepared to become HROs.
Improvements
Medical facilities need to implement improvements if their vision of becoming HROs is to be realized. There are a number of measures that they can adopt. One of these measures concerns leadership. The leaders of healthcare organizations need to be in the forefront in the effort to embrace the HRO model (Chassin & Loeb, 2013). It is particularly important for nurses to lead the charge. Leaders should also adopt scientific principles and approaches that have been shown to enhance patient safety. Creating a culture that places focus on safety is another measure that medical facilities should adopt (Chassin & Loeb, 2013). They should remind stakeholders of the need for patient safety. Investment in process refinement is yet another measure that promises to accelerate the transformation of medical providers into HROs (Chassin & Loeb, 2013). In the discussion above, it was pointed out that the processes that most facilities rely on are incompatible with HRO. For these facilities to become HROs, they simply must refine their processes. One of the defining features of HROs is that their employees are too concerned about failure. Each employee is anxious about how a breakdown in their operations could affect the organization (Gamble, 2013). Healthcare organizations need to challenge their staff to agonize and reflect on the danger that recklessness poses. As they do this, the organizations will be helping to enhance patient safety.
Role of patient, provider and other stakeholders
The strategies recommended above are rather complex. Effort from all concerned stakeholders is needed to transform medical facilities into HRO. The provider, patient and other stakeholders have specific and clear roles that they should play. Creating a culture of safety and challenging leaders to push for reform are some of the measures that the provider can institute (Chassin & Loeb, 2013). On their part, patients should demonstrate initiative when seeking care. Patients tend to wait too long before seeking medical services. If they truly wish to help practitioners in improving safety, patients should seek medical assistance as soon as possible. Other stakeholders such as sponsors also have a role to play. In an earlier discussion, inadequate funding was identified as among the barriers that have kept healthcare providers from becoming HROs. Sponsors can help to address this barrier through the provision of sufficient finances.
Potential interest of payer
In the US healthcare system, various stakeholders are charged with the mandate of paying for healthcare. Insurance providers, the government and patients are the key stakeholders. Each of these stakeholders would have interests in the HRO. The main interest of the payer is to receive value for their money. Medical services in the United States are notoriously costly (Burwell, 2015). As they adopt the HRO model, medical facilities will be able to lower the cost of care, thereby delivering value to money to the payers. The payers would also be interested in patient safety. For example, patients would demand quality and safe care. Overall, the party paying for medical services would expect quality, affordable and safe medical care.
In conclusion, healthcare facilities continue to perform the important role of promoting human health. However, these facilities have been facing challenges in their attempts to deliver quality and safe care. The HRO model promises to change this. This model is borrowed from organizations in high-risk industries which have achieved impressive and enviable safety levels. In their quest to adopt this model, medical facilities encounter hurdles. The facilities should move with speed and eliminate these hurdles. There is particular need for leaders to remind medical practitioners of the importance of patient safety.
References
Burwell, S. M. (2015). Setting Value-Based Payment Goals- HHS Efforts to Improve U.S. Health Care. New England Journal of Medicine, 372 (10), 897-899.
Chassin, M. R. & Loeb, J. M. (2013). High-Reliability Health Care: Getting there from here. Milbank Quarterly, 91 (3), 459-490. DOI: 10.1111/1468-0009.12023
Christianson, M. K., Sutcliffe, K. M., Miller, M. A. & Iwashyna, T. J. (2011). Becoming a High Reliability Organization. Critical Care, 15 (6). DOI: 10.1186/cc10360
Gamble, M. (2013). 5 Traits of High Reliability Organizations: How to Hardwire Each into your Organization. Retrieved 29 th January 2018 from https://www.beckershospitalreview.com/hospital-management-administration/5-traits-of-high-reliability-organizations-how-to-hardwire-each-in-your-organization.html
Grabowski, M. & Roberts, K. H. (2016). Reliability Seeking Virtual Organizations: Challenges For High Reliability Organizations and Resilience Engineering. Safety Science. DOI: https://doi.org/10.1016/j.ssci.2016.02.016
Mira, J. J., Lorenzo, S. & Navarro, J. (2014). Hospital Reputation and Perceptions of Patient Safety. Medical Principles and Practice, 23 (1), 92-94. DOI: 10.1159/000353152
Transforming into a High Reliability Organization in Health Care. (n.d). Retrieved 29 th January 2018 from https://www2.deloitte.com/content/dam/Deloitte/us/Documents/life-sciences-health-care/us-lshc-health-care-high-reliability-organization.pdf
