Healthcare High Reliability Organization Highly Reliable CareWhat is Highly Reliable Care?

Healthcare is a high risk environment. People’s lives are saved (and lost) every minute of the day based upon the pressing decisions of healthcare workers in the midst of stressful situations. In order to save lives and prevent future harms, caregivers need to have a foundational mindset that guides them through every interaction and decision. This is no different than many other high risk environments such as the military and first responders. There are clear differences in healthcare, however, that call for a similar, but unique, mindset.

Currently, high risk industries are utilizing principles of High Reliability Organizations (HRO). In HRO, the main premise of successful high risk organizations is that they continually reinvent themselves with “mindfulness” that keeps them working well when facing unexpected situations. TSD Healthcare has developed the parallel to HRO for Healthcare in Highly Reliable Care (HRC). HRC is care that succeeds in proactively avoiding harm in an environment where normal harm can be expected due to risk factors and complexity. HRC guides caregivers with four main principles:

  1. Preoccupation with Harm – placing a face on harm
  2. Reluctance to simplify interpretations – healthcare is complex, ensuring not going to apparent causes immediately
  3. Sensitivity to operations – Leveraging relationships to reduce harm in multi-disciplinary settings
  4. Learning organization – using a “what can we do by Tuesday/AAA: Adapt, Adopt or Abandon” approach and learning to improve processes following harm incidents

Delivering the safest care for our patients is becoming increasingly important as harm events are highly visible to the public. In a day where patients have a choice of where to receive their care and hospitals are penalized for harm events, it is imperative that caregivers focus on potential harms and are proactive in implementing strategies to mitigate future harms. HRC provides that structure and guidelines to achieve these goals and TSD Healthcare has seen significant (approximately 70%improvements in harm prevention when applying HRC with our partner hospitals.

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