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Matthew Brice

Matthew Brice

Studer Group, Australasia

Title: The high reliability challenge: Zero harm in healthcare, beginning the journey

Biography

Biography: Matthew Brice

Abstract

First do no harm. Most clinicians would not knowingly harm their patients, however as an industry healthcare harms patient at an alarming rate. This burden is felt directly by patients and families, by clinicians and has implications for access to healthcare, patient flow and availability of scarce resources. The root cause of this problem lays in the highly complex and fractured nature of healthcare culture and delivery. There are however organizations that work in inherently complex and high-risk environments and yet appear to do so for extend periods without experiencing significant adverse events; these are known as High Reliability Organizations (HROs). These organizations bring together culture and systems that result in an observable approach to work. These have been described by Weick and Sutcliffe as: (1) Preoccupation with failure, (2) Reluctance to over-simplify, (3) Sensitivity to operations, (4) Commitment to resilience, and (5) Deference to expertise. These attributes are not programs or slogans, but the outcome of long term transformational processes. To achieve high reliability in healthcare is a huge undertaking, however there are already well-established and evidence based approaches to cultural and system transformation in healthcare that can be used to lay the foundation. Long term and consistent application of the Evidence-Based Leadership™ (EBL) framework has been demonstrated to facilitate organizational alignment of goals, alignment of behaviors and alignment of processes. Each of these phases builds towards the organization’s ability to achieve the ‘collective mindfulness’ needed to deliver consistently high-quality results in risky and complex environments. High reliability in healthcare is both desirable and achievable. The foundational strategies currently exist to begin working toward zero harm and zero waste, the question is: “Are we willing to take the journey?”