Assignment Overview

Consider the last time you were a passenger on an airplane. You placed implicit trust in not only the pilot, but the ground crew, flight attendants, and the entire operation of the airline. You felt safe enough to do so, because the airline industry is considered to be highly reliable. In order for people to not only feel safe enough to fly in an airplane, but to actually be safe, the entire airline industry must be focused on safety-the stakes are high and each and every organization must embrace the values inherent in the expectation of high reliability.

Like the airline industry, the health care industry holds lives at stake every day. Each individual in each organization must be focused on avoiding failure and providing a critical service in order to deliver optimal patient outcomes. How to best establish these values in every health care organization is the focus of this week's topic. You will examine different management and project management tools and quality improvement programs which accomplish this goal.

In this week, you will begin to explore the development of high reliability by identifying how a long-term care facility can meet the criteria of the Baldrige Performance Excellence Program. You will then write an executive summary of this analysis for an audience consisting of the board of directors of the institution.

Learning Objectives

Students will:
- Identify elements which meet the criteria of a high-reliability health care organization
- Analyze the impact of becoming a high-reliability organization on patient care
- Analyze the impact of becoming a high-reliability organization on organizational competitive advantage and performance

Assignment Topic: High Reliability in Health Care - Long-Term Care

There are three imperative steps that need to be taken. The first is a strong commitment by leadership to this very high level of safety and quality. The leadership must set the goal and example for everyone in order to achieve high reliability. The second is to embed all of the principles and practice of a culture of safety throughout the organization which emphasizes trust, reporting of unsafe conditions, and highly effective improvement over time. The third step is to utilize powerful Robust Process Improvement tools like Six Sigma, Lean, and change management to create near perfect processes, similar to the tools that we see in industries like commercial aviation today, and sustain very high levels of safety over long periods of time.

These three steps: commitment by leadership, development of a culture of safety, and the use of process improvement tools, are the core recommendations made by Dr. Chassin, the president of The Joint Commission and the president of the Joint Commission Center for Transforming Healthcare. A first step in identifying whether these recommendations are being met is to compare elements of an organization to criteria which have been identified as essential to high-reliability organizations.

To prepare for this Assignment:

Consider the three steps described by Dr. Chassin and the seven major criteria of the Baldridge Performance Excellence Program, and reflect on how these recommendations can apply to health care organizations, specifically to long-term care facilities.

The Assignment:

In this Assignment you will identify major elements of high-reliability organizations providing long-term care. According to the Baldrige Performance Excellence Program (MBNQA), the criteria are as follows:
- Leadership
- Strategic planning
- Customer and market focus
- Measurement, analysis, and knowledge management
- Human resource focus
- Process management
- Business/organizational performance results

Using the Highly Reliable Organization Matrix located in this week's Learning Resources, complete the matrix by typing in the elements which meet the criteria in rows and columns. Describe each element briefly, give an example as to how this can be met in a long-term care facility, and explain the expected impact on patient care.

Based on the results of the Highly Reliable Organization Matrix, write a 1- to 2-page executive summary to the board of directors of the long-term care organization, describing elements which meet the criteria from the matrix and how any missing elements of the criteria for excellence can be met.