5 must-haves for the next chapter in patient safety innovation

The next wave in patient safety innovation will come in the form of “high- reliability organizing,” an approach that emphasizes how individual team members interact, according to patient safety experts in a blog post from the Harvard Business Review.

High-reliability organizing operates around the idea that high performance takes more than data analysis; it requires organizations to look at human interaction and communication on a day-to-day basis.

"Contrary to technical or structural innovations that aim to reduce variation and dictate one way of operating, organizing emphasizes the varying actions that can affect patient safety,” write the four authors, who Peter J. Pronovost, M.D., Kathleen M. Sutcliffe and Christopher Myers, all from Johns Hopkins University, and Amir A. Ghaferi from the University of Michigan.

While patient safety requires some standardization by nature, taking it too far ignores the differences between individual people, potentially increasing the risk, they said.

For example, the authors point to research that finds similar rates of surgical complications at hospitals with high mortality rates and those with low rates. In other words, they write, improving outcomes is more than avoiding complications; it involves how individual providers respond to those complications.

The problem, they argue, is not hospitals’ broader lack of patient safety but their “failure to rescue,” which hinges on interpersonal dynamics and coordination between members of the team. Recognition of this need has led to innovations such as the comprehensive unit-based safety program, developed by Johns Hopkins Medicine and the Armstrong Institute. According to 2012 research, the program cut surgical site infections up to 33 percent.

To create a culture that fosters such high-reliability outcomes, the authors write that providers must make sure their organizations are:

  • Acutely aware of the consequences of failure
  • Reluctant to oversimplify interpretations of complex concepts
  • Sensitive to operations
  • Resilient
  • Look to experts wherever possible

- here’s the post