High Reliability Organization (HRO)
In 1999, the Institute of Medicine released a report called "To Err is Human" stating that between 44,000 to 98,000 people die every year from medical errors. That's the equivalent of a Boeing 747 crashing every day.
Like hospitals and healthcare institutions across the country, Griffin Hospital recognizes the inherent dangers and complex risks of providing comprehensive care on a daily basis and continuously seeks ways to improve our systems and practices to improve safety at every level.
Intense Focus on Safety Behaviors Error Prevention
Working closely with the Connecticut Hospital Association, Griffin Hospital is intently focused on safety behaviors and error prevention. In 2007, Griffin Hospital adopted the Institute of Medicine Six Dimensions of Patient Care and in 2012 began its vigorous pursuit of the High Reliability Organization (HRO) designation through an intensive HRO program and operating strategy.
An Ongoing Commitment to Patient-Centered Care
As an institution long committed to patient-centered care, Griffin Hospital constantly and continuously seeks to improve reliability and intervene both to prevent errors and failures and to identify issues and react quickly should errors or safety issues become known. This is the hallmark of becoming a High Reliability Organization (HRO).
The Connecticut Hospital Association has partnered with Healthcare Performance Improvement, Inc. (HPI) to create and sustain a culture of reliability across healthcare that can significantly reduce events of harm in organizations by applying LEAN principles (reducing waste); SIX SIGMA principles (reduction of variation) with a "People Bundle" that teaches staff throughout the organization to identify how errors occur and events happen; how to prevent errors and apply a series of safety habits and behaviors through error prevention tools.
The Five Key Principles of a High Reliability Organization include:
- Preoccupation with Failure: Actively looking or and being aware of what can go wrong
- Sensitivity to Operations: Open information about what is happening on the front line
- Reluctance to Simplify: Encouraging questioning attitudes and seeing clarification when unsure
- Commitment to Resilience: Detect, Contain, Learn and Bounce back from Errors
- Deference to Expertise: Decision making during high stress, high volume activity goes to the person with the most experience rather than title
The Four Key Components Include:
- Clarifying Safety as essential core value of patient centered Care
- Adapting High Reliability Leadership Principles and methods to sharpen skills and reduce variation
- Adapting Behavioral Expectations for error prevention as both individual and team habits
- Optimizing Event analysis Capabilities and improving organizational learning from events of harm
Practicing High Reliability, Each and Every Day
Griffin Hospital holds daily Organizational Safety Huddles; shares Safety Stories at each meeting and applies principles of a "Just Culture." The hospital has trained Safety Coaches and is teaching staff to be Safety "CHAMPs" by adhering to the following practices:
C: Communicate Clearly
Repeat and Read Backs, Clarifying Questing, using phonetic and numeric clarifications.
H: Hand-Off Effectively
Using SBAR (Situation, Background, Assessment and Recommendations)
A: Attention to Detail
Using STAR (Stop, Think, Act, Review)
M: Mentor Each Other with 200% Accountability
Cross-checks and coaching; speak up for safety using ARCC (ask question, request a change, voice concern, go up chain of command)
P: Practice and Accept a Questioning Attitude
Validate and Verify, Stop the Line for clarification