NR533: Quality Improvement and Patient Safety

  In one page, I need to write a Reflective Journal
Reflective Journal – Planning a High Reliability Journey
High Reliability Mindset & Five Principles of High Reliability Organizations
In this video presentation, Frank Federico, BS, RPh, Executive Director, Institute for Healthcare Improvement brings it all together, in other words, the journey to high reliability. Mr. Federico introduces his presentation with the following question: Why do we want to take the journey to high reliability?
Federico, F. (n.d.). Bringing it all together: The journey to high reliability. Barnes Jewish Hospital, Washington University in St. Louis.  (37 min)
NOTE: The link will show a warning in your browser. The CISO of Norwich University has checked and the link is safe to use. Click ‘advanced’ then click button to proceed to video.
Based on Mr. Federico’s presentation, How close or far away is your healthcare organization from the state of high reliability?
 In your Reflective Journal answer the following questions:

How do the characteristics of your own organization compare with the journey to high reliability as described by Mr. Federico.
Describe your organization’s commitment to patient safety and high reliability.
Where does your healthcare organization currently stand on the journey to high reliability?
What is the healthcare organization’s plan or next steps on the high reliability journey?

The Journey to High Reliability
What is foundational?

Have clear aims that all can understand and support

Creating a world where patients and those who care from them are free from harm. National       Patient Safety Foundation (2014, January)

Strategic plan

Agree on the path
Use an improvement methodology
Build capability and capacity
Do not forget to engage middle managers
Understand the psychology of change

Portfolio management

Align with organizational aim?
Refine, refine and refine

Leadership at all layers of an organization

Individuals and families are partners in their care
Compete on value, with continuous reduction in operating cost
Reorganize services to align with new payment systems
Everyone is an ‘improver’

Design for resilience engineering


Error reduction: Hierarchy of controls

Standardization and simplification

Improvement methodology

Tool kit for improvement, e.g. Lean, Six Sigma, Model or Improvement/PDSA
Improvement is a way of life

High reliability processes
Safer health care through transparency

Between clinicians and patients, e.g. disclosure after a medical error
Among clinicians, e.g. peer review
With the public, e.g. public reporting of safety data
Among organizations, e.g. regional collaboratives


Psychological safety
Deference to expertise

Situational awareness and huddles

Last modified: Tuesday, February 16, 2021, 4:07 PM

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