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Analysis

Let Hospital Staff Lead Quality Improvement Efforts

By Tinker Ready  
   November 10, 2016

In the midst of an unprecedented "change management experience," the AHA's top quality executive wants leaders to take a page from other industries that must successfully manage high-risk processes.

Hospitals nationwide are enduring an unprecedented "change management experience," says Jay Bhatt, DO, who took charge of several of the American Hospital Association's quality efforts this summer, including the AHA's Health Research and Educational Trust.

Bhatt recommends that healthcare leadership take lessons from other industries that must manage change to avoid major harm or catastrophes.

He champions "high reliability" to improve safety at hospitals. High reliability is the technique of standardizing high-risk processes, and is used in nuclear power, aviation, and other industries where errors can have disastrous consequences.

Some organizations—including Medstar Health in the Washington, DC area and Advocate Health Care in Chicago—are moving toward higher reliability, says Bhatt.


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"There are hospitals in which there over 900,000 blood transfusions without a mismatch, or three years without a catheter-based infection, or a million prescriptions without an error," he says.

In high-reliability hospitals, staff members are "sensitive to operations," he says. "Leadership is aware of how different processes and systems effect the organization… Each member of the staff is really thinking about those operations."

That creates an internal learning system that produces real-time feedback on what is working and what isn't. That involves leveraging the best evidence and learning instead of assuming, he says.

"Problems are complicated, and sometimes we want to jump to easy answers," Bhatt says. "But I like to step back off the dance floor and onto the balcony to see what is happening on the dance floor."

Tinker Ready is a contributing writer at HealthLeaders Media.


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