Assignment: High Reliability in Health Care – Long-Term Care There are three imperative steps… 

Assignment: High Reliability in Health Care – Long-Term Care

There are three imperative steps that need to be taken. The first is a strong commitment by leadership to this very high level of safety and quality. The leadership must set the goal and example for everyone in order to achieve high reliability. The second is to embed all of the principles and practice of a culture of safety throughout the organization which emphasizes trust, reporting of unsafe conditions, and highly effective improvement over time. The third step is to utilize powerful Robust Process Improvement tools like Six Sigma, Lean, and change management to create near perfect processes, similar to the tools that we see in industries like commercial aviation today, and sustain very high levels of safety over long periods of time.

—Dr. Mark R. Chassin

These three steps: commitment by leadership, development of a culture of safety, and the use of process improvement tools, are the core recommendations made by Dr. Chassin, the president of The Joint Commission and the president of the Joint Commission Center for Transforming Healthcare. A first step in identifying whether these recommendations are being met is to compare elements of an organization to criteria which have been identified as essential to high-reliability organizations.

The Assignment:

In this Assignment you will identify major elements of high-reliability organizations providing long-term care. According to the Baldrige Performance Excellence Program (MBNQA), the criteria are as follows:

Leadership

Strategic planning

Customer and market focus

Measurement, analysis, and knowledge management

Human resource focus

Process management

Business/organizational performance results

Using the Highly Reliable Organization Matrix located in this week’s Learning Resources, complete the matrix by typing in the elements which meet the criteria in rows and columns. Describe each element briefly, give an example as to how this can be met in a long-term care facility, and explain the expected impact on patient care.

Based on the results of the Highly Reliable Organization Matrix, write a 1- to 2-page executive summary to the board of directors of the long-term care organization, describing elements which meet the criteria from the matrix and how any missing elements of the criteria for excellence can be met.

Highly Reliable Organization Matrix
Criteria for Performance Excellence*	Inpatient	Skilled Nursing	Ambulatory Care	Public Hospitals	Private/Not for Profit
Leadership
Strategic planning
Customer and market focus
Measurement, analysis, and knowledge management
Human resource focus	Example: The staffing ratio of nurses to patients is lower in highly reliable health care organizations.
Process management
Business/organizational performance results
* Reference: Malcolm Baldrige National Quality Award (MBNQA)