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*TS: Benchmark: Performance Measurement Leads the Way to High Reliability[®] [REF: GB, JCSC, PI, LDR] The Source, July 2014, Vol 12, #7, Pg 14 JCs1407_B5 Healthcare organizations (e.g., hospitals) are generally reported as performing at the level of 1-2 sigma. This means something goes wrong (i.e., a failure) once in every 10 to 100 opportunities. On the other hand, airlines and nuclear plants are given as examples of High Reliability Organizations performing at the level of 6 sigma. This means things go wrong (i.e., failures) not more than 3.4 times in every one million opportunities. This article begins with a Key Def of ‘High Reliability Organization’ and a useful overview/review of the 3 critical changes an organization must undergo to achieve HRO status:
The bulk and balance of the article explicates that third factor of RPI and performance measurement. It points out that “The purpose of data collection is to find the areas of care that can be improved and then to implement solutions to improve that care.” It also encourages transparency in the sharing of performance data. In the beginning this might just be with staff, but ultimately it should progress to patients and even external bodies. A [Pearl] useful list of required data to collect as well as optional data suggestions is included on page 17. |
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Key Definitions from Performance Measurement Leads the Way to High Reliability, The Source, July 2014, Vol 12, #7, Pg 14:
Key Def: High Reliability Organization (HRO) –
• High reliability organizations are those that demonstrate consistent performance at high levels of safety over long periods of time.
Key Def: Accontability Measure –
• The Joint Commission’s accountability measures are
quality measures that meet the following four criteria designed to identify measures that produce the greatest positive impact on patient outcomes when hospitals demonstrate improvement6:
1. Research: Strong scientific evidence demonstrates
that performing the evidence-based care process
improves health outcomes (either directly or by
reducing risk of adverse outcomes).
2. Proximity: Performing the care process is closely
connected to the patient outcome; there are relatively
few clinical processes that occur after the one that is
measured and before the improved outcome occurs.
3. Accuracy: The measure accurately assesses whether
or not the care process has actually been provided.
That is, the measure should be capable of indicating
whether the process has been delivered with sufficient
effectiveness to make improved outcomes likely.
4. No Adverse Effects: Implementing the measure has
little or no chance of inducing unintended adverse
consequences.
Key Def: DMAIC –
• Acronym consisting of the following:
– Define the problem.
– Measure key aspects of the current process and
collect relevant data.
– Analyze data to investigate and verify cause-and-effect
relationships.
– Improve or optimize the current process based on
data analysis.
– Control the future state process to ensure that any
deviations from the target are corrected before they
result in defects.