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High Reliability Healthcare Organizations

By Jenny Palmgren, BSN, RN, Clinical Nurse Manager, MSSI

Every year, patients continue to suffer from preventable setbacks including medication errors, adverse reactions, and falls with injuries and infections. These issues could be a minor setback (or even lead up to death) but as healthcare providers we tend to get overwhelmed with the many day-to-day tasks of the job and the ever-demanding and increasing healthcare needs of patients. Despite this, it is extremely important to do our due diligence to care for these patients. It is best to treat a patient as if they were your own family. Short-cuts are not okay as that could be the one thing that can cost someone their life.

The core goal is to have zero harm or defects.  This is accomplished by doing the right thing and the right way every time. All caregivers need to be consistent in how goals are achieved.

Here is an example of not being a highly reliable organization – I was listening to someone tell a story about someone they knew who was in their early thirties and was admitted to the hospital for chest pain. As many of us know, chest pain in a young patient is typically muscular/anxiety. Basic nursing was missed and an EKG was not completed. The patient continued to have chest pain and later went into cardiac arrest and died. Per the story, the patient had a massive heart attack. This was a very preventable error that cost someone their life and their family heartache. It goes to show us that we should take every complaint serious as you never know what the outcome can be.

Following these characteristics below will help organizations lead to exceptional care with desired outcomes for the patients served.

  • Showcase your expertise: Although it is important that all parties share their concerns with an event, it is the bedside staff that are most important when it comes to the patients and any concerns that may arise. They have the expert knowledge to know the ins and out to the patient care and what impact may arise with similar events.
  • Seeing the big picture: All staff should be aware of the overall goals to assist with patient safety, but also coordinating with leadership to ensure steps in place are the best for the patient outcomes.
  • Be resilient: Be adaptable to the unexpected outcomes that can happen to patients and how to improve outcomes.
  • Work process safeguards: Near-misses happen often and should not be viewed as punitive, but rather to assist in prevention and create best practices for future care. Report minor occurrences through the reporting system to help with process improvement.
  • Avoid simple explanations: When a process is not working it is easy to make vague or “simple” excuses, but it is highly important to dig deep for the root of the problem. Finding the root of the problem will allow for processes to improve and remain consistent versus just placing a Band-Aid on the problem.

Be the caregiver you want to be recognized for as you worked hard to get to this point in your career for a reason!

MSSI has earned the Joint Commission’s Gold Seal of Approval

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