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High reliability


“Patients are thus on the front lines of healthcare; they are the experts in ‘patienthood’ and we need to seek and value their input also.”


errors, especially when we expect our patients to successfully implement care plans. We really do not partner very well, and most of this is driven by a 


4. Deference to expertise: leaders and supervisors listening to and seeking  risks arise.


Standard organizational charts are used to portray the relationships of authority and responsibility in hospitals. Typically missing from   crossing the organizational lines and communicating, those who provide the most pragmatic aspects of work in the hospital and who touch the patients and hold the hands of family members. These are the nurses and doctors who know how the processes really work and where risks arise, and whose perspectives are enormously important.


  because, unlike the aviation industry, which often is viewed as the quintessential HRO, patients are not simply passengers passively           highly engineered airplanes. Achieving safe outcomes is enormously complex, especially when treating the desperately ill and individuals with multiple co-morbid conditions. Patients are thus on the front lines   seek and value their input also.


5.            challenges. For HROs, resilience means dealing with emergencies, preventing translation of these mishaps into harm and instituting corrective actions.


The Institute for Healthcare Improvement (IHI) has prepared a white paper advising hospitals on how to plan for patient safety crises. The key elements of this white paper focus on honestly and compassionately disclosing information to patients and their family members and also           individuals are treated appropriately and fairly when errors occur.


Only by planning and training can further injury be avoided and malpractice claims avoided or reduced by processes of disclosure, transparency and, most important, accountability and apology.


32 | HEALTHCARE RISK MANAGEMENT REVIEW | Annual 2014


If the healthcare industry is a forest of complexities, then two giant coastal redwood trees set it apart from other HROs. These giants are (1) the frequency of human-to-human interactions that result in increasing complexity inherent in the challenges associated with communication; and (2) a highly appropriate world view that envisions patients not just as passive recipients of healthcare services, but rather as essential components in a system appropriately focused on achieving optimal and safe healthcare outcomes.


Communication and partnering with patients for active engagement and 


Also available from Dr Dan Cohen: Achieving High Reliability in Healthcare: Late Night Thoughts can be downloaded at: http://www.datix.co.uk/ news-and-events/publications/achieving-high-reliability-in-healthcare/


                   


     


ABOUT DAN COHEN Dr Dan Cohen was formerly chief medical officer and executive medical director for the US Department of Defense health plan that provides or purchases healthcare services for more than nine million beneficiaries worldwide. As director, office of the chief medical officer, Dr Cohen was


responsible for important aspects of oversight for clinical quality, patient safety, population health and medical management initiatives across this comprehensive system.


He trained in pediatrics and hematology/oncology at the Boston Medical Center, Boston University, and the Boston Children’s Hospital, Dana Farber Cancer Institute, Harvard Medical School. He is a Senior Fellow of the Royal College of Paediatrics and Child Health and a Fellow of the American Academy of Pediatrics. He retains a faculty appointment in the Department of Pediatrics at the Uniformed Services University of the Health Sciences, F. Edward Hébert School of Medicine, Bethesda, Maryland, US, where he once served as dean for student development. Datix can be contacted at: info@datixusa.com


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