Improving long-term care services: insights from high-reliability organizations

Area of Science:

• Healthcare Management
• Organizational Studies
• Public Health

Background:

• Long-term care (LTC) facilities faced significant challenges during the COVID-19 pandemic, highlighting deficiencies in traditional safety and management practices.
• Existing outbreak containment strategies in LTC settings have proven insufficient for ensuring resident safety during crises.
• A critical reassessment of traditional management approaches is necessary to address the vulnerabilities exposed in LTC organizations.

Purpose of the Study:

• To propose a paradigm shift in LTC management by drawing parallels with High-Reliability Organizations (HROs).
• To identify how HRO principles can enhance the resilience and crisis management capabilities of LTC organizations.
• To advocate for a fundamental rethinking of LTC organizational attributes for improved safety and reliability.

Main Methods:

• Qualitative data analysis from a Canadian LTC facility.
• Examination of current reliability practices and organizational culture within the LTC industry.
• Assessment of the strengths and weaknesses of conventional management strategies in LTC.

Main Results:

• Traditional management approaches in LTC exhibit significant weaknesses in handling unexpected and demanding conditions.
• There is an urgent need for a systemic, top-down approach in LTC to build crisis management capacity.
• Cultivating mindfulness, continuous learning, and resilience is essential for enhancing LTC reliability.

Conclusions:

• Applying the High-Reliability Organization (HRO) theoretical lens to LTC offers valuable insights for industry leaders.
• The study provides a framework for LTC leaders to foster a unified, industry-wide effort towards high reliability.
• Adopting HRO principles can transform LTC organizations into more robust and resilient entities, better prepared for future crises.