Becoming a High Reliability Organization

Operational Advice for Hospital Leaders

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This document is written for hospital leaders interested in providing patients safer and higher quality care. It presents the thoughts, successes, and failures of hospital leaders who have used concepts of high reliability to make patient care better. High reliability concepts are tools that a growing number of hospitals use to help achieve their safety, quality, and efficiency goals. Creating a culture and processes that radically reduce system failures, and effectively respond when failures do occur is the goal of high reliability thinking.

Prepared for the Agency for Healthcare Research and Quality (AHRQ) by The Lewin Group and The Delmarva Foundation.

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Contents

Copyright Information and Disclaimer
Executive Summary
Transforming Hospitals Into High Reliability Organizations
  Introduction and Overview
What are High Reliability Organizations and Why Do They Matter?
  Challenges Calling for High Reliability
  High Reliability Organizing Concepts
  Using High Reliability Concepts in Hospitals
Applying High Reliability Concepts in Hospitals
  Changing and Responding to the Hospital's Environments
  Planning and Implementing Improvement Initiatives
Approaches to Doing Work
Approaches to Measuring Progress
  Measurement Insights
  Specific Measurement Areas
  Specific Improvement Initiatives
  Spreading Improvements to Other Units and Facilities
Using This Information
References
Acknowledgments
Appendixes
Appendix A: Sentara Site Visit
Appendix B: Exempla Site Visit
Appendix C: Cincinnati Children's Site Visit
Appendix D: Allina/Fairview Site Visit
Appendix E: Case Studies: Sentara
Appendix F: Case Studies: Christiana Care
Appendix G: About the HRO Network

Copyright Information and Disclaimer

This document is in the public domain and may be used and reprinted without permission except those copyrighted materials noted for which further reproduction is prohibited without the specific permission of the copyright holders.

The authors of this report are responsible for its content. Statements in the report should not be construed as endorsement by the Agency for Healthcare Research and Quality (AHRQ) or the U.S. Department of Health and Human Services.

AHRQ Publication No. 08-0022
Current as of February 2008

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Internet Citation:

Becoming a High Reliability Organization: Operational Advice for Hospital Leaders.. AHRQ Publication No. 08-0022, February 2008, Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/qual/hroadvice/

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