In 2008, Don Berwick introduced the Triple Aim to the Centers for Medicare and Medicaid Services (CMS) as a transformative program for healthcare.
This framework requires healthcare organizations to be committed to true transformation, safety and continuous improvement. Adoption of a safety culture and the associated principles of high reliability will assist healthcare organizations in achieving all of these goals. High reliability organizations are those organizations that succeed in avoiding catastrophes in environments where normal accidents can be expected due to risk factors and complexity. According to the Agency for Healthcare Research and Quality (AHRQ), organizations that adopt the principle of high reliability usually adhere to safety culture principles including:
· Acknowledgement of the high-risk nature of the work and the drive to do this work safely
· A “blame-free environment” where everyone is empowered to report errors or near misses without fear of reprisal
· Cross-functional collaboration where everyone involved in a process has a voice despite their position title
· Leadership and organizational commitment to providing the resources needed to improve safety
How does a strong safety culture address all aspects of the Quadruple Aim of healthcare?
· A safety culture enhances the patient experience and quality of care by helping to reduce medical errors and incidents.
· Population health improvement comes when errors and re-admissions are reduced and health systems are able to help their at-risk groups better understand ways to avoid injuries and comply with medical direction.
· Cost reduction and finance goals are supported by work that reduces waste, workers compensation claims, re-admissions and legal costs.
· Provider experience directly benefits as providers reduce the potential to face a devastating error on their professional record and work-related injuries or incidents that also can have a devastating effect on a clinical career.
Virginia Davis, R.N., Ed.D., C.P.H.Q. is the principal clinical consultant for DuPont Sustainable Solutions, the safety culture consulting division of DuPont. She can be reached at virginia.davis@mail3.dupont.com
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