Question

If the goal is how to develop reliability and resilience in health care systems while embedding a vision of zero avoidable harm into the culture of health care is it possible to reach "zero harm".

Describe what achieving this goal requires(what does an organization have to do).

Answer 1

Answers:

Zero Harm :

“Zero harm” refers to the concept of not having any patients harmed as a result of their interactions with a health care system. As clinicians work to improve quality and safety for patients, some have been able to reach the ideal concept of zero harm.

“But the goal of zero harm should become everyone’s new mantra and, to get there, health care providers need to add new dimensions to their typical quality improvement and patient safety efforts,”

Develop reliability and resilience in health care systems :

As the proverb goes ‘Prevention is better than cure’, organisations that focus on zero harm rather than trying to minimise risk after an incident are deemed ‘highly reliable’. Industries such as aviation and nuclear power succeed in preventing harm by implementing safety systems with the concept of collective mindfulness and pursuing a zero-defect environment. Healthcare industry is no different as the risk here is with health and lives of people, be it patients or staff. With increasing patient expectations, advancements in technology, achieving zero harm is the key for healthcare industry and organisations alike as delivering effective care continues to be a challenge.

Medical errors cost lives of millions all over the world; the data from American Hospital Association (AHA) indicatesmedical errors lead to four times more deaths than motor accidents. Whether it is lack of communication about potential health risks or absence of quality care providers, the result could be loss of lives.

In order to attain zero harm in their industry, health leaders have to prepare themselves for supporting high reliability by committing and focusing on providing quality care and safety for every patient, every time. The onus lies on the leaders to trust their teams to deliver quality healthcare with high levels of patient safety. The entire team has to work on the same measure with a common goal and vision.

The frontline workers need to find the errors and unsafe conditions and report them to their leaders for consistent adherence to safe practices. The leaders, in turn, have to self-assess and reassess various areas for process improvements. This is done to anticipate or detect potential problems early and always respond to early enough to prevent catastrophic consequences.

How realistic or attainable is the goal of zero harm :

Mindsets regarding preventing harm have changed over the past few years, particularly around healthcare-acquired infections like central line infections or ventilator-associated pneumonia. We thought we could never eradicate them, and it was just a part of doing business. Now, we're actually seeing organizations get to zero harm for long periods of time for those specific infections. If you take that thinking and extrapolate it, it really is possible — with the right technology, mindset, skills and leadership — to create an organization that is so strong that zero harm is a byproduct of what they do

How Organization to achieve Zero harm :

An organisation is said to be High Reliability Organisation (HRO) only when it is in the next level in pursuit of quality and process improvements. The Joint Commission (JCI) suggests that hospitals and healthcare organisations create a strong foundation as they embark on the transformation journey to be an HRO. The JCI coined the term ‘robust process improvement’ to encapsulate an approach that includes Lean Six Sigma and change management philosophies, methodologies and tools. Applying HRO concepts does not require a huge campaign or a major resource investment. It begins with leaders at all levels acknowledging the need to provide better care and prevent medical errors that cost lives and most importantly establishing a culture of safety for patients and healthcare staff both.

There are three major characteristics of a highly reliable organization in healthcare.

The first is a leadership commitment to zero harm. It isn't just about setting the goal of zero harm for the organization, but also making sure it is attainable by aligning resources around the goal.

Second is a safety culture. The employees within an organization, including leadership, must recognize when harm could occur. They need to be able to bring up unsafe conditions and opportunities for improvement. They must also be able to solve and address the issues they bring up.

The third characteristic is strong, robust process improvement skills. Performance improvement should be a common skill set in healthcare. There needs to be massive training on quality improvement so people do it as part of their daily work.