Becoming a highly reliable leader


Whether you’re a nurse leader, physician leader, or administrative leader, you function in high-risk, high-stress environments where you continuously strive to improve employee and physician engagement as well as operational efficiency, quality and safety.

If your goal is to become a high reliability organization (HRO), one that has predictable and repeatable systems in place allowing for consistent execution of operations while catching and correcting potentially harmful errors, you must be a highly reliable leader.

An efficient, error-free operation that reduces variation in human behavior helps ensure your organization reduces (and ultimately eliminates) events of harm. This highly reliable environment also improves measures of operational efficiency and excellence as well as care delivery quality as measured by HCAHPS and other patient experience surveys.

If you want to confirm you are a highly reliable leader or want to achieve a state of high reliability in your leadership practices, below are four steps designed to help.

1. Renew your commitment to excellence. No one said a journey to high reliability would be easy; if it was, you’d already be where you want to be. It’s important to acknowledge the barriers you, your team, and your organization face. The most effective sustainable improvement plans are rooted in a firm personal commitment of each member of the leadership team. And it’s okay if you need to recommit every day… many of us do!

2. Commit to achieve or maintain your leader rounding. Rounding on people, physicians and patients is an evidence-based leadership practice. Rounding when you can get to it won’t suffice as you journey to high reliability. Dedicate time on your calendar for your leader rounding, make it a priority, demonstrate strong leader discipline around it and make it a true MUST HAVE behavior.

3. Delegate where and what you can. If you want to achieve high reliability with your leader rounding, you may need to clear your plate a bit. Believing you need to do everything is a slippery slope for leaders. Consider this: you need more time to complete high reliability leader behaviors and have staff who are eager to add more value and take on more responsibility. Isn’t this a match made in heaven?

4. Leverage your 90-day plan. Include rounding and other essential high reliability leadership behaviors in your 90-day plan. Update it weekly and review it monthly with your one-up leader during your supervisory meetings. This level of self-accountability will really serve you well.

This is always true: full engagement of team members is a foundational and essential component of high reliability and to achieve zero harm and near-flawless operations, you need a fully engaged team. Staff, physicians and leadership team colleagues depend heavily on the c-suite to be present, effective and efficient. Use these tips to create predictability and process consistency in your leader rounding behaviors. Highly reliable leaders lead high reliability organizations.

Vikki Choate, MSN, RN, NEA-BC, CCM, CPHQ, is a coach leader and international speaker at Studer Group. She brings her passion for high reliability, clinical and operational improvement to her role, inspiring organizations to strive for excellence. Highly trained and experienced in care delivery process improvement, she helps organizations implement meaningful and lasting change. As a health care leader for over 35 years, she offers a depth of experience and clarity of vision that consistently delivers results.

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