Jan L. Bergen, CEO, Lancaster General Health

I think we all can agree that there is nothing more important than ensuring that we eliminate the possibility of harm to our patients. To truly accomplish this, we must continue to focus on continuous improvement, building a culture of safety and becoming a highly reliable organization.

The term “high reliability” is not new to industries like aviation or manufacturing, but its application to health-care organizations has only recently begun to take hold.  In this column, I will outline what it means to be a high-reliability organization and why I feel so strongly that Penn Medicine Lancaster General Health must continue to adopt best practices that will lead us to zero harm.

The Agency for Healthcare Research and Quality defines high-reliability organizations as those that successfully engage in complex, high-stakes work where errors can cause great harm. Achieving success in these environments -- or operating for an extended period without a serious error -- comes only from relentlessly prioritizing safety above all use.  

Research has shown that high-reliability organizations share five characteristics:

  • Preoccupation with failure: All staff members are actively aware of what could go wrong and alert to small signs of potential problems. Everyone feels comfortable reporting near-misses, which are viewed as opportunities to learn.
  • Reluctance to simplify: Because our work is complex and dynamic, uncovering the true explanation for our successes and failures often requires digging in and asking a lot of questions.
  • Sensitivity to operations: This trait describes “situational awareness,” or the understanding of how our work and what is happening around us can either support or threaten safety.
  • Deference to frontline expertise: Having status or seniority isn’t the same as having all the answers. The people closest to the work are usually the most knowledgeable about the work.
  • Commitment to resilience: Anticipation and early detection of potential threats lead us to recover more quickly from an error, limiting potential harm.

Because of your hard work and dedication, and our history of providing high-quality care, LG Health is uniquely positioned to be one of the first health systems in the nation to achieve high-reliability. 

Through our huddle system, we are daily identifying safety risks and empowering everyone to speak up about identified concerns. High reliability is a natural extension of our ongoing commitment to continuous improvement and patient safety, and consistent with our organizational mission and values.

Keeping our patients, their families and each other safe is the most important thing we do every day. Becoming a high reliability organization will enable us to achieve our aspiration of eliminating harm to every person in our care. I look forward to sharing much more with you as our efforts continue to evolve.

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