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NATIONAL HARBOR, Md. — Hospital systems and other health care facilities are implementing a “high reliability” regimen to reduce serious safety events, health care risk managers said Monday.
The high-reliability approach requires: philosophical and financial commitments and support from senior-level management; designation of frontline “champions” to facilitate and oversee implementation and ongoing participation, detailed corollary studies of claims data and persistent risk factors; and participation mechanisms designed to maximize employees' ease of use, a panel of risk managers said during the American Society for Healthcare Risk Management's annual conference in National Harbor, Md.
“I think the hardest part about migrating towards the high-reliability culture is actually making an authentic move toward that culture,” said Mary Anne Hilliard, chief risk counsel at the Washington-based Children's National Medical Center. “If it's the kind of thing that started in the risk management office; and if that's really the only place it lives, you're really not going to get anywhere. It really has to be the kind of thing that your leadership and your board of directors want to do.”
A central tenet of making the high-reliability approach part of the employee culture is an emphasis on vigilance, panelists said. Hospital employees should not only be encouraged at every level of management to freely report falls, infections, lacerations and other incidents involving patient harm, but should be given a clear, simplified protocol to file those reports.
“We have one central location for physicians to report incidents, and that's the risk management office,” said Jacque Mitchell, risk manager at Sentara Norfolk General Hospital in Norfolk, Va. “We've worked very hard to make it clear to physicians that they need to report those incidents to us, and even the physicians that don't work directly for the hospital or come to us from a medical school are very much in tune to the idea that they need to call us to let us know what's going on.”
Other key components of successful integration of a high-reliability culture are the standardization and correlation of data sets to measure the frequency, severity and root cause of patient injury claims, panelists said. In particular, risk managers seeking to identify and understand trends in their patient injury data should consider how other culturally significant events and initiatives occurring within the hospital system may affect safety
“One thing that fails to get captured in data analyses is the notation of significant events as they're occurring,” said Kathy Connolly, president and owner of Charlotte, N.C.-based health care risk management consulting group KT Connolly & Associates L.L.C. “We had a significant number of (health) systems implement electronic medical records management systems, and something like that can be a major disruption to patient injury reduction as people tend to lose focus on some the safety projects you had going on.”
For more coverage of the ASHRM conference, click here.