A High-Reliability Organization or HRO is one that consistently achieves its targets and successfully averts calamitous errors. Can a medical practice be ambitious enough to try their hand at becoming an HRO ?
In medical practice, there is a pressing need for more and more precision and elimination of errors, especially since human lives are at stake. A safety net that helps reduce the rate of morbidity, mortality, and complications has become an absolute must for such entities. Aside from the usual issues that plague healthcare facilities, errors of commission like incorrect billing or coding, poor auditing practices and the inability to adhere to Federal or State regulations can also lead to deleterious results. Providers can lose their licenses, face severe penalties, and ultimately their ability to practice medicine.
If you run a medical office and are keen on converting it into a safe, high-reliability organization, here are six principles that you cannot ignore:
- Integrity – An essential requirement for creating a high-reliability medical office is to have a leader who is passionate and is willing to learn continually, grow and challenge himself or herself. This kind of engagement is possible only through absolute integrity toward the task of creating an HRO.
- Deep Knowledge – A learning organization that puts a high premium on attaining knowledge is the perfect setup for the creation of an HRO. Intense specialization and mastery of the subject along with organizational expertise can be very beneficial in such an endeavor. In-depth knowledge allows practitioners to uncover potential issues that can blow out of proportion later.
- Procedural Compliance – Every HRO is built on a strong foundation of compliance. The need for adhering to regulatory and legal requirements is a quality that should be instilled in every employee. It is crucial to train and test the staff periodically to reach such a high level of compliance. Evaluating and appraising their ability to follow procedures is a non-negotiable practice that needs to be conducted routinely.
- Forceful Backup – Forceful backup does not necessarily mean establishing a rigid hierarchy. Supervisors should be able to manage employees effectively and also possess in-depth knowledge that they are ready to share with their subordinates on a regular basis. It is critical for them to observe prospective hires keenly, interview them and share feedback often.
- A Questioning Attitude – It is vital for an organization to foster a culture of systemic and systematic awareness that allows employees to envision possible pitfalls. People should be encouraged to speak up and share concerns or any instinctive discomfort to prevent potential problems. They should also be motivated to question orders and not follow them blindly, to share novel ideas and to present innovative new ways of doing things.
- Formality In Communication – An HRO is characterized by a communicative culture that is non-hierarchical and, therefore, minimizes the chances of errors due to miscommunication and lack of comprehension. For instance, the new developments in Advanced Cardiac Life Support, or ACLS, protocols are not in the area of new medications but team communications. These include making a team effort to resuscitate the patient. The nurses are expected to ask doctors if they would consider trying another medication or repeating the request for a particular infusion for the patient to confirm that they heard it correctly.
Only those medical offices that are willing to be agile, resilient, sensitive, open, transparent, and committed will be prepared enough to embark on an evolutionary journey towards a high-reliability setup. Complacency is eschewed in such facilities, learning is prized, and errors are minimized to prevent failures.
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