Organization-wide approaches to patient safety

Abstract

The Institute of Medicine’s report, To Err is Human, raised the public awareness of medical errors and medical harm. However, even after 10 years following the release of this report, studies showed that safety had not significantly improved in health care. In order to address the ongoing concerns with medical errors and harm, many health care organizations have started to learn from other industries, including the automobile industry, the nuclear power industry, commercial aviation, and the military. Many of these industries are so-called high reliability organizations (HROs), which are defined as organizations that possess certain cultural characteristics that allow them to operate in highly dangerous environments with near-perfect safety records. In this context, health care organizations should learn from HROs and try to adopt some of these characteristics in order to improve safety, by ultimately becoming HROs themselves. While it is clear that HROs are not the definitive or even the only answer, many hospitals that have adopted techniques, skills, knowledge, and behaviors of HROs have started to make significant progress in improving patient safety. The purpose of this review is to highlight some of the approaches that HROs use to improve safety, with a specific emphasis on how health care organizations can apply some of these approaches to improve patient safety.