High Reliability in Health Care Long-Term Care

There are three imperative steps
that need to be taken. The first is a strong commitment by leadership to this
very high level of safety and quality. The leadership must set the goal and
example for everyone in order to achieve high reliability. The second is to
embed all of the principles and practice of a culture of safety throughout the
organization which emphasizes trust, reporting of unsafe conditions, and highly
effective improvement over time. The third step is to utilize powerful Robust
Process Improvement tools like Six Sigma, Lean, and change management to create
near perfect processes, similar to the tools that we see in industries like
commercial aviation today, and sustain very high levels of safety over long
periods of time.
Dr. Mark R. Chassin

These three steps: commitment by
leadership, development of a culture of safety, and the use of process
improvement tools, are the core recommendations made by Dr. Chassin, the
president of The Joint Commission and the president of the Joint Commission
Center for Transforming Healthcare. A first step in identifying whether these
recommendations are being met is to compare elements of an organization to
criteria which have been identified as essential to high-reliability
organizations.
Consider the three steps described
by Dr. Chassin and the seven major criteria of the Baldridge Performance
Excellence Program, and reflect on how these recommendations can apply to
health care organizations, specifically to long-term care facilities.

Write:

Identify major elements of
high-reliability organizations providing long-term care. According to the
Baldrige Performance Excellence Program (MBNQA), the criteria are as follows:
Leadership
Strategic planning
Customer and market focus
Measurement, analysis, and knowledge management
Human resource focus
Process management
Business/organizational performance results
Using the Highly Reliable
Organization Matrix attached, complete the matrix by typing in the elements
which meet the criteria in rows and columns. Describe each element briefly,
give an example as to how this can be met in a long-term care facility, and
explain the expected impact on patient care.
Based on the results of the Highly
Reliable Organization Matrix, write a 2-page executive summary to the board of
directors of the long-term care organization, describing elements which meet
the criteria from the matrix and how any missing elements of the criteria for
excellence can be met.

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