Premier Health – A High Reliability Organization

By Mark Williams, MD, Vice President, Chief Medical Officer, Miami Valley Hospital

At Premier Health, we are involved in one of the most highly complex systems – health care. Having adapted ideas from other highly complex, high-risk industries such as aviation, nuclear power, and the military, our industry is constantly transforming. Each day, we are forced to quickly develop new ways to respond to unexpected events. We must prepare ourselves to function in the presence of uncertainty as an aspect of daily operations as each patient and family situation brings unique challenges.

Because of the complexities inherent in healthcare, Premier Health is on a journey to becoming a “high reliability organization” (HRO).

An HRO is an organization that is exceptionally consistent in accomplishing its goals, and avoiding potentially catastrophic errors in an environment where adverse events can be expected, due to risk factors and complexity.

At Premier Health, we expect that, as members of an effective health care community, we must continue to develop a highly effective team of individuals sharing common attitudes. Despite the wonderful things we do for patients as health care providers, we must make an intensive effort to consistently recognize, acknowledge, and learn from our mistakes and near misses, in order to close loopholes in processes where there is potential for patient harm, and devise systems and processes that improve reliability.

Through initiatives such as patient experience, daily check-in, and executive rounding, we are improving communication and encouraging transparency, so that every employee and physician feels as though they can make a difference within Premier Health. Our distinctive efforts to improve are becoming hardwired into our culture. Whether it's reporting a safety concern to a leader during rounding, proposing an idea to improve patient safety, or working with team members to develop a new skill set - asking the “why” question and inviting others with diverse experience to express their opinions has become everyone’s responsibility. Every physician and employee is encouraged to think of ways that work processes might break down, and are encouraged to share their concerns for potential failures, which can help create best practices across departments.

As we continue our journey toward developing a culture of HRO - patient safety, organizational transparency, and helping people do the right thing – it is important that we continue to challenge normal routines to help queue up physicians’ and employees’ awareness and interest in achieving the level of reliability that our patients and families expect and deserve.


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