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Caveats for high reliability in healthcare
Peter F Martelli1, Peter E Rivard1, Karlene H Roberts2
1Sawyer Business School, Suffolk University , Boston, Massachusetts, USA.
Journal of Health Organization and Management
|September 4, 2018
Summary
Healthcare organizations face challenges applying high reliability organization (HRO) principles due to industry changes. This study explores theory-practice gaps in integrated systems and patient-centered care for improved research and practice.
Area of Science:
- Healthcare Management
- Organizational Theory
- Patient Safety
Background:
- Rapid industry changes and high reliability organization (HRO) diffusion create gaps between healthcare research and practice.
- Existing HRO models may not fully address the complexities of modern integrated healthcare systems.
Purpose of the Study:
- To explore theory-practice gaps in healthcare related to HRO principles.
- To analyze the impact of industry trends like delivery system integration and patient-centered care on HRO application.
- To propose implications for future research and practice in high-reliability healthcare.
Main Methods:
- Analysis of classic and cutting-edge high reliability organization (HRO) literature.
- Application of HRO concepts to examine industry trends in healthcare delivery.
- Evaluation of the confluence of patient-as-consumer and patient-centered care models.
Main Results:
- Highly reliable integrated delivery systems present unique operational challenges compared to traditional HROs.
- New considerations include system boundaries, desired reliability levels, and interdependency management.
- Increased patient agency introduces variability and uncertainty into care processes.
Conclusions:
- Healthcare integration necessitates adapting HRO principles to new challenges and opportunities.
- Research must address cross-organizational reliability and the shift of decision-making power to patients.
- Practitioners need to understand how integrated systems differ from classic HROs when implementing reliability strategies.
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