A case of the birth and death of a high reliability healthcare organisation

Roberts, Karlene H.; Madsen, Peter; Desai, Vinit M.; Stralen, Daved van

doi:10.1136/qshc.2003.009589

Cited by 97 publications

(65 citation statements)

References 6 publications

(1 reference statement)

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“…HROs are defined by their ability to perform reliably and safely in the face of complexity and dynamism and include industries such as commercial and military aviation, the nuclear power industry and firefighting 9. While several HRO frameworks specific to healthcare have emerged,11 12 transformation remains elusive,13 improvements remain modest and patient harm continues to be pervasive 14…”

Section: Methodsmentioning

confidence: 99%

Huddling for high reliability and situation awareness

et al. 2013

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Background Studies show that implementing huddles in healthcare can improve a variety of outcomes. Yet little is known about the mechanisms through which huddles exert their effects. To help remedy this gap, our study objectives were to explore hospital administrator and frontline staff perspectives on the benefits and challenges of implementing a tiered huddle system; and propose a model based on our findings depicting the mediating pathways through which implementing a huddle system may reduce patient harm. Methods Using qualitative methods, we conducted semi-structured interviews and focus groups to obtain a deeper understanding of the huddle system and its outcomes as implemented in an academic tertiary care children’s hospital with 539 inpatient beds. We recruited healthcare providers representing all levels using a snowball sampling technique (10 interviews), and emails, flyers, and paper invitations (six focus groups). We transcribed recordings and analysed the data using established techniques. Results Five themes emerged and provided the foundational constructs of our model. Specifically we propose that huddle implementation leads to improved efficiencies and quality of information sharing, increased levels of accountability, empowerment, and sense of community, which together create a culture of collaboration and collegiality that increases the staff’s quality of collective awareness and enhanced capacity for eliminating patient harm. Conclusions While each construct in the proposed model is itself a beneficial outcome of implementing huddles, conceptualising the pathways by which they may work allows us to design ways to evaluate other huddle implementation efforts designed to help reduce failures and eliminate patient harm.

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Section: Methodsmentioning

confidence: 99%

Huddling for high reliability and situation awareness

et al. 2013

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“…Instead, such units will likely need safety organizing to be coupled with other interventions to ameliorate emotional exhaustion. For example, it may take specific leader actions to foster safety organizing, 9,68 while simultaneously illustrating its importance in the absence of adverse events (eg, refreshing caregivers' memories of prior events, 65 explicitly connecting safety organizing to beneficiaries of it 23 ). Safety organizing was also associated with lower unitlevel turnover rates.…”

Section: Discussionmentioning

confidence: 99%

Safety Organizing, Emotional Exhaustion, and Turnover in Hospital Nursing Units

et al. 2014

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“…Health care facilities therefore have to conduct relatively error free operations and make consistently good decisions resulting in high quality and reliability (Roberts, Madsen, Van Stralen, & Desai, 2005). Health care organizations are exposed to a higher level of risk since they deal with people's lives.…”

Section: The Health Care Aspectmentioning

confidence: 99%