Unit 4 Individual Project HCM672 HIGH RELIABILITY ORGANIZATIONS & PATIENT SAFETY
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Feb 20, 2024
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HIGH RELIABILITY ORGANIZATIONS & PATIENT SAFETY
Unit 4 Individual Project
Quality Improvement in Healthcare
HCM672
Vincent L. Smith
January 28, 2024
HIGH RELIABILITY ORGANIZATIONS & PATIENT SAFETY
1
ABSTRACT
This unit 4 individual project assignment will explore and examine the concept of high
reliability organizations also known as (HROs). This project assignment will also attempt to
discuss or explain how these (HROs) make it possible to transform the manner or method in
which health care is provided or delivered. Healthcare for the most part has had a difficult time
in some instances when it comes to transforming into a more organized culture of delivering
quality care and services. HROs in many instances are viewed as an attractive method or process
for helping to manage health care organizations or facilities. HROs tend to be both resilient and
persistent when it comes to making safety a main priority over performance goals and objectives.
Health care organizations or facilities face three critical factors which may limit the possibility
of becoming a fully successful HRO. These factors are based on regulations, performance and
complexity when it comes to overall healthcare. Studies and research performed by members of
the Joint Commision, discovered that certain aspects of HROs and the manner or method in
which they develop and increased levels of safety may be applied to hospitals or medical
facilities when dealing with complexities associated with health care. It is imperative to
remember and comprehend that an HRO also has five key principles to building or developing a
successful HRO. They are preoccupation with failure, sensitivity to operations, deference to
expertise, resilience and reluctance to simplify (Battar et al., 2019).
HIGH RELIABILITY ORGANIZATIONS & PATIENT SAFETY
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HROs are those organizations which manage to operate or function within environments
considered to be both hazardous and complex over long or extended periods of time without the
cause of any unforeseen incident that may be defined as being serious. Well designed and
planned HROs work in a manner that helps to develop a safe and sound working environment
while also managing to anticipate possible problems that may hinder the success of the HRO.
Reasons for some health care organizations only having very little progress or success when
trying to establish a successful HRO when dealing with poor performance issues and financial
concerns. In some cases payment models used for improving services and quality may not
always be in agreement with some within the organization who prefer to measure and define the
methods and procedures for quality health care. The Centers for Medicare and Medicaid Services
(CMS) along with other regulatory groups define or recognize value somewhat differently as
opposed to HROs when it comes to hospital/medical facilities, care providers and patients. This
could possibly lead to or cause a conflict in the manner or safety is used when providing or
administering health care, measuring and improving quality when going against barriers that may
interrupt the process of adopting the principles or concepts of an HRO (Battar et al., 2019)
Various programs of the government (federal, state and local), help to regulate the health
care system along with private organizations. When private insurance companies or agencies are
factored into the mix, these companies and agencies tend to implement their own rules and
procedures for getting reimbursed. This in some cases may cause a conflict when it comes to
standards of providing safe and quality health care that is acceptable. Conflicting guidelines can
develop barriers which will eventually block or hinder the adoption of those principles necessary
for forming an HRO (Battar et al., 2019).
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Complexity in healthcare when it comes to establishing guidelines for safety is another key
factor or difficult reason for health care organizations to adopt principles or methods of HRO.
Since there is much in terms of care, safety and quality when it comes to providing for the needs
of the community, safety in health care can prove to be a complex issue for concern. When
dealing with complex issues that hinder the adoption principles of an HRO the number of
components being operated or developed for this process tend to increase. In other words a
health care facility may have various specialities all operating or functioning at once such as, a
pharmacy, primary care offices, surgical departments and nutritional clinics just to name a few.
However, there are some instances where health care organizations can utilize improvements that
will make it possible to embrace or adopt those principles of an HRO. Other methods or
procedures that may prove useful when trying to adopt those practices or principles of HRO may
consist of shifting or moving away from a culture of blame on either an individual or group when
it pertains to an error or mistake to a culture where the organization takes blame and
responsibility for those errors or mistakes committed by both the organization and its staff. In
situations regarding medical mistakes or adverse events, both patients and shareholders find that
it is important to either blame or point the finger at someone. However, HROs have managed in
many instances to transition or convert from a perception of blame. It is accepted by HROs that
organizations will make mistakes and also comprehends that identifying or recognizing the initial
cause of the mistake can help to boost operations and provide information for lessons learned.
The method or procedure of not passing blame will help to improve lines of communication and
increase the organizations ability to learn from those mistakes while also improving both safety
and quality. Patients and shareholders must comprehend the complexity of any system within the
HIGH RELIABILITY ORGANIZATIONS & PATIENT SAFETY
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health care organization will have its share of problems or hindrances, however, the best method
for improving the system is with communication, guidance, understanding and trust. Care
providers must also realize the phrase that
“to err is human” and learn to admit to and of their
mistakes. This can only help to further improve trust and confidence of their care and decision
making when it involves the patient (Leape, 2021).
Being proactive and not reactive when it comes to safety issues and concerns is another
method or process that can help to improve an HRO when it comes to health care. HROs can be
very effective when trying to identify and recognize possible safety concerns when it involves
the patient. Providers and organizational shareholders must observe all processes when
recognizing those threats that place the health and well being of the patient at risk without
waiting for those mistakes to happen prior to improving any method or process for the purpose of
patient safety. Organizational leadership is generally tasked with the responsibility for seeking
out possible mistakes that may hinder the success of the health care organization and harm to the
patient. Since care providers are basically viewed as the frontline caregivers t is critical for them
to quickly recognize those risk and the manner in which they can affect the care of the patient
while also having the responsibility for speaking up and being accountable. In some ways the
patient will have a similar responsibility in that they must also speak up and follow those
instructions for self care without acting blindly when it comes to their health as well.
Understandably the patient instances will defer to the expertise of the care provider when it
comes to their health, however if there are any doubts or questions about the particular care or
treatment they are receiving, then it is imperative that they speak up immediately.
The importance of payers within an HRO, other than trying to maintain outcomes based on
safety, is basically one of reduced or limited costs due to the organization having an increased
HIGH RELIABILITY ORGANIZATIONS & PATIENT SAFETY
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responsibility in the manner that health care strategies are implemented. Payers, both public and
private are progressively holding those care providers accountable when it comes to quality and
costs based on the success of the hospital or health care facility pending the ability to gain
improved efficiency and outcomes. This is due to organizations having the ability to reduce
adverse events, reduce readmission rates and deliver a more effective form of treatment and care
for the patient.
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References
AHRQ. (2019, Sept). High Reliability. Retrieved from Agency for Healthcare Research and
Quality: https://psnet.ahrq.gov/primer/high-reliability
Battar, S., Kr, W. D., Sedgwick, C., & Cmelik, T. (2019). Understanding principles of high
reliability organizations through the eyes of VIONE: a clinical program to improve
patient safety by deprescribing potentially inappropriate medications and reducing
polypharmacy. PubMed, 36(12), 564–568. https://pubmed.ncbi.nlm.nih.gov/31892781
Clapper, C., Merlino, J., & Stockmeier, C. (2018). Zero Harm: How to achieve patient and
workforce safety in healthcare: How to Achieve Patient and Workforce Safety in
Healthcare. McGraw Hill Professional.
Leape, L. L. (2021). Making healthcare safe: The Story of the Patient Safety Movement.
Springer Nature.
Veazie, S., Peterson, K., & Bourne, D. (2019, May). Retrieved from National Library of
Medicine: https://www.ncbi.nlm.nih.gov/books/NBK542883/