High Reliability Organizations, Second Edition: A Healthcare Handbook for Patient Safety & Quality

by Cynthia A Oster, Jane S Braaten

Overview

Awarded second place in the 2021 AJN Book of the Year Awards in Professional Issues!

Nurses represent the majority of healthcare workers and are on the front lines of delivery and provision of safe and effective care. As a result, nurses are ideally situated to drive the mission to achieve high reliability in healthcare. We expect the primary audience of this text to be frontline nursing staff, nurses in administration, quality and patient safety professionals, advanced practice nurses, and nurse educators. The healthcare professional who purchases this book will do so with the desire to learn more about the application of HRO principles to patient safety and quality problems. This book is unique in that it uses HRO principles as an organizing framework for practical application. The intent of the editors is to provide a quality and patient safety book that is useful to professionals doing the work of healthcare.

Healthcare professionals are constantly seeking practical tools and descriptions of practices that will improve and enhance patient safety and quality outcomes. High reliability is a current goal for hospitals, and the principles are sound. However, there is little in the literature that discusses how to apply the principles at the front lines of care to improve outcomes. This text addresses this gap by placing the need for high reliability concepts into our current climate in healthcare through illustrative discussion (theory and research) of each of the five concepts of HRO, along with a description of a current best practice and/or tool that applies to the model. The goal of this book is to stimulate organizations to embrace high reliability concepts while striving to improve the quality and safety of care delivered to patients and families. We all benefit from a safer healthcare environment.

The book is divided into eight parts:

Part 1: This part provides background for the current safety and quality climate.

Parts 2-6: These parts offer HRO concepts as a framework for the new model with examples.

1. The first of these HRO concepts is that HROs have a preoccupation with failure.
2. The second of these HRO concepts is that HROs restrain the impulse to view events through a single lens and are reluctant to simplify.
3. The third HRO concept is that HROs demonstrate sensitivity to operations by making strong responses to weak signs.
4. The fourth HRO concept is that HROs shift decision making away from formal authority and apply deference to expertise.
5. The final HRO concept is that HROs have a commitment to resilience.

Part 7: This part puts it all together and provides the reader with examples of how HRO concepts are assimilated into practice across the care continuum.

Part 8: This part provides the reader with real-world examples of HRO principles employed in a variety of patient care areas.

Comprehensive Instructor's Guide and Student Workbook are available for this book.

Product Details

ISBN-13:	9781646482061
Publisher:	SIGMA Theta Tau International
Publication date:	11/30/2020
Edition description:	2nd ed.
Pages:	594
Product dimensions:	8.50(w) x 11.00(h) x 1.25(d)

About the Author

CYNTHIA A. OSTER, PhD, MBA, APRN, ACNS-BC, CNS-BC, ANP, FAAN, is a Patient Safety Nurse Scientist at Emory Healthcare and an adjunct Assistant Professor at the Nell Hodgson Woodruff School of Nursing at Emory University. With 40 years of experience, she has held research, clinical, educational, and administrative positions throughout her career.

JANE S. BRAATEN, PhD, APRN, CNS, ANP, CPPS, CPHQ, is a Patient Safety Manager and Nurse Scientist at Centura Health. She has held positions within Centura Health as Director of Cardiology Services, Cardiac and Intensive Care Clinical Nurse Specialist, Cardiac Nurse Practitioner, and Manager/Charge RN/Staff RN of intensive care and telemetry units.

Table of Contents

Part 1: High Reliability - The Time Is Now

Chapter 1: The Need for a Paradigm Shift in Healthcare Quality and Safety Thinking

Chapter 2: Current Patient Safety Drivers

Chapter 3: Current Quality Drivers

Chapter 4: Organizational Culture and the Journey to HRO

Chapter 5: Safety Leadership: Commitment to High Reliability Organizing

Part 2: HRO Concepts and Application to Practice: Preoccupation With Failure

Chapter 6: Using Failure Mode and Effects Analysis to Predict Failure

Chapter 7: Close Calls and Near Misses: What's the Big Deal?

Part 3: HRO Concepts and Application to Practice: Reluctance to Simplify

Chapter 8: Human Factors Engineering for Reducing and Recovering From Error

Chapter 9: Root Cause Analysis: A Tool for High Reliability in a Complex Environment

Chapter 10: Just Culture and the Impact on High Reliability

Part 4: HRO Concepts and Application to Practice: Sensitivity to Operations

Chapter 11: Alarm Safety: Working Solutions

Chapter 12: Innovative Technology, Standardization, and the Impact on High Reliability

Chapter 13: Tiered Safety Huddles

Part 5: HRO Concepts and Application to Practice: Deference to Expertise

Chapter 14: Interprofessional Collaboration

Chapter 15: Nurses Create Reliable Care by Enhancing Engagement

Chapter 16: Pediatric Patient Safety: Utilizing Safety Coaching as a Strategy Toward Zero Harm

Part 6: HRO Concepts and Application to Practice: Resilience

Chapter 17: Resilience: A Path to HRO

Chapter 18: Designing Resilience Into the Work Environment

Chapter 19: Building High Reliability Through Simulation

Chapter 20: Building Resilience Through Team Training: Rapid Response and In-Hospital Cardiac Arrest Events

Chapter 21: Sustaining a Culture of Safety: Strategies to Maintain the Gains

Part 7: Assimilation Into Practice Across the Continuum

Chapter 22: Application of HRO Strategies to Improve Pain Management and Opioid Safety: The CNS Role

Chapter 23: Ambulatory Care: The Frontier for High Reliability

Chapter 24: Applying High Reliability Principles Across a Large Healt

Editorial Reviews

"Enhancing your people's adaptive capacity on the front lines makes all the difference-that is where resilience gets made and eroded. Healthcare systems, however, have a hard time getting that message through. Adding protocols, guidelines, policies, processes, and structures is easy, Oster and Braaten observe, but we should instead be understanding and supporting how practitioners on the front lines make successful outcomes occur in complex, dynamic environments. In this new edition of their push to change patient safety thinking, they have an A-list lineup of contributors exploring just how that might work in their (and your) area of patient care."

Sidney W. A. Dekker, MA, MSc, PhD

Professor

Safety Science Innovation Lab

Griffith University, Australia, and Delft University, the Netherlands

"Oster and Braaten have captured the essence of high reliability organizations, and this highly readable guide inspires organizations to do the right things to protect their patients while providing them with the tools to do so. The authors' experiences in these fields show, as each chapter is filled with attention to human aspects of high reliability as well as practical recommendations for creating high performance. These authors-themselves considered experts in the field-have assembled an impressive group of contributors to create this comprehensive text that answers both the 'why' and the 'how' of quality and patient safety efforts. They bring a fresh, contemporary approach to a complex organizational challenge and a guide to achieving the state of high reliability, even in challenging times."

Janet Houser, PhD, RN

Provost, Regis University, Denver

Author, Nursing Research: Reading, Using and Creating Evidence, 5th Edition 

"This is an outstanding resource for anyone interested in the theory and practice of high reliability organizing in healthcare. The 32 chapters in this thoughtfully organized handbook present a wide-ranging mix of theoretical frameworks, practices, and implementation strategies. The attention to the critical role of leadership, culture, and context in enhancing the reliability of healthcare delivery is especially noteworthy. This timely update is a welcome addition to the literature."

Rangaraj Ramanujam, PhD

Richard M. and Betty Ruth Miller Professor of Healthcare Management

Owen Graduate School of Management

Vanderbilt University

"The global quest to prevent patient harm and improve care quality and safety is paramount across all healthcare delivery settings. The second edition of High Reliability Organizations elucidates the connection among human and organizational factors, effectively integrating theory with pragmatic examples of health systems' progress and challenges. Shifting practice paradigms require effective use of innovation and technology to advance and sustain improved patient safety outcomes. Noteworthy new information includes content on the COVID-19 pandemic, resilience-building strategies, ambulatory care delivery, and telehealth considerations."

Ann Scott Blouin, PhD, RN, LFACHE

President, PSQ Advisory, Ltd.

Board and Executive Committee Member, Institute for Healthcare Improvement

Assistant Professor, Marcella Niehoff School of Nursing, Loyola University Chicago

From the Publisher