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High reliability


RAISING THE SAFETY BAR


Dr Dan Cohen, International Medical Director, Datix, explains what healthcare can learn from high reliability organizations.


interactions between humans and technologies, it is the humans that represent the most substantial sources of risk. Structurally, and culturally, continuous safety monitoring and quality improvement is quintessentially embedded in these organizations.


H It has been argued that if the healthcare industry would simply adopt the


characteristics of HROs, we would move the bar for safety higher and would continuously improve outcomes. If this is true, then why, in an industry with professionals so deeply committed to improving health, is there such inertia in our system, inertia that plagues our improvement strategies?


THE HEALTHCARE INDUSTRY IS DANGEROUS FOR PATIENTS AND STAFF Every day thousands of patients are harmed and hundreds die in        intentions do not necessarily translate to safety, however, and the reasons for this are numerous. The healthcare industry is dangerous 


30 | HEALTHCARE RISK MANAGEMENT REVIEW | Annual 2014


igh reliability organizations (HROs) are dangerous industries that have established cultures and processes designed to reduce the likelihood of system failures and human errors that often result in harm. HROs recognize that in the


  impact. The patients who are injured or die are not merely numbers on a bar graph. They are mothers and fathers, children and grandparents who will now miss graduations, weddings, births and celebrations, all the joys of life.


The challenge is to understand how so many things can go wrong when the intention is to achieve quality outcomes. How can we tolerate so much risk when we know that the outcomes of such tolerance are injuries, deaths and associated malpractice claims and litigation? Why is high reliability not part of our culture when it is obviously so relevant, crucial, and urgent?


THE HEALTHCARE INDUSTRY HAS UNIQUE CHARACTERISTICS My perspective is that the healthcare industry possesses a variety of unique characteristics that interfere with adoption or adaptation of many HRO processes. Even though the principles that work in HROs can be  that encumber our processes and that may not apply to other industries.


The guiding principles of HROs have been summarized by Weick and 


1. 


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