Ebook Leading reliable healthcare: Part 1

Part 1 book “Leading reliable healthcare” has contents: Organizational safety culture, operational excellence, efficient clinical practice, successful patient outcomes, high reliability organizations, information technology - a neural network for reliable healthcare, healthcare education and training to support a responsive healthcare system - canadian perspectives.

Leading Reliable Healthcare  Leading Reliable Healthcare  Edited by Bandar Abdulmohsen Al Knawy CRC Press Taylor & Francis Group 6000 Broken Sound Parkway NW, Suite 300 Boca Raton, FL 33487-2742 ©  2018 by Taylor & Francis Group, LLC CRC Press is an imprint of Taylor & Francis Group, an Informa business No claim to original U.S Government works Printed on acid-free paper International Standard Book Number-13: 978-1-138-19751-0 (Hardback) International Standard Book Number-13: 978-1-3152-7758-5 (eBook) This book contains information obtained from authentic and highly regarded sources Reasonable efforts have been made to publish reliable data and information, but the author and publisher cannot assume responsibility for the validity of all materials or the consequences of their use The authors and publishers have attempted to trace the copyright holders of all material reproduced in this publication and apologize to copyright holders if permission to publish in this form has not been obtained If any copyright material has not been acknowledged please write and let us know so we may rectify in any future reprint Except as permitted under U.S Copyright Law, no part of this book may be reprinted, reproduced, transmitted, or utilized in any form by any electronic, mechanical, or other means, now known or hereafter invented, including photocopying, microfilming, and recording, or in any information storage or retrieval system, without written permission from the publishers For permission to photocopy or use material electronically from this work, please access www.copyright.com (http://www.copyright.com/) or contact the Copyright Clearance Center, Inc (CCC), 222 Rosewood Drive, Danvers, MA 01923, 978-750-8400 CCC is a not-for-profit organization that provides licenses and registration for a variety of users For organizations that have been granted a photocopy license by the CCC, a separate system of payment has been arranged Trademark Notice:  Product or corporate names may be trademarks or registered trademarks, and are used only for identification and explanation without intent to infringe Library of Congress Cataloging‑ in‑ Publication Data  Names: Al Knawy, Bandar Abdulmoshen, author Title: Leading reliable healthcare / Bandar Abdulmoshen Al Knawy Description: Boca Raton ; London : Taylor & Francis, 2018 | “A CRC title, part of the Taylor & Francis imprint, a member of the Taylor & Francis Group, the academic division of T&F Informa plc.” | Includes index Identifiers: LCCN 2017022041| ISBN 9781138197510 (hardback : alk paper) | ISBN 9781315277585 (ebook) Subjects: LCSH: Medical errors Prevention | Medical care Quality control | Health facilities Safety measures Classification: LCC R729.8 A44 2018 | DDC 610.28/9 dc23 LC record available at https://lccn.loc.gov/2017022041 Visit the Taylor & Francis Web site at  http://www.taylorandfrancis.com  and the CRC Press Web site at  http://www.crcpress.com  Contents Foreword vii Preface ix Acknowledgments xi About the Contributors xiii Organizational Safety Culture SALLIE J WEAVER AND HANAN H EDREES Operational Excellence 25 SUSAN MASCITELLI, STEPHEN S MILLS, MICHAEL BIERL, AND RYAN LE Efficient Clinical Practice 45 SANDRA L FENWICK, KATHY J JENKINS, JOHN G MEARA, CHRIS NEWELL, ANNE STACK, SARA TOOMEY, AND CYNTHIA HAINES Successful Patient Outcomes .71 CALEB FAN, SAMI EL-BOGHDADLY, AND MARTIN A MAKARY High Reliability Organizations  83 FRANK FEDERICO, AMELIA BROOKS, AND HANAN H EDREES Information Technology: A Neural Network for Reliable Healthcare 111 HEE HWANG Healthcare Education and Training to Support a Responsive Healthcare System: Canadian Perspectives .123 STEVE SLADE, TANYA HORSLEY, AND ANDREW PADMOS Integration of Primary Healthcare and Hospitals 135 F.D RICHARD HOBBS AND CLARE J TAYLOR Performance Parameters 155 JULES MARTIN, ALISON ALSBURY, AND WILL REYNOLDS 10 Quality and Cost in Healthcare: Improving Performance 189 BRUNO HOLTHOF 11 Leadership through Crisis .205 BANDAR AL KNAW Y v vi  ◾ Contents 12 Health System Innovation and Reform 217 TARA DONNELLY 13 The Financial Aspects of Leading a Reliable Healthcare System 231 CHRIS HURST Index 241 Foreword Plenty of books debut each year, promising to be the definitive guide to change management in healthcare In fact, the shelves in my office at Johns Hopkins Medicine are crammed full of such texts Yet few of these volumes pull off what Dr Bandar Al Knawy has managed with this edition—namely, compiling insightful, practical perspectives from experts around the globe who have pioneered innovations in medical practice and clinical operations in the name of providing consistently excellent care Medical professionals can glean a number of lessons from the examples gathered herein, whether it be a snapshot of how the National Health Service in England has managed to maximize primary care networks or a glimpse into how one Saudi Arabian hospital responded to a MERS outbreak in the emergency department These are concise takes on critical issues, grounded in realworld examples and up-to-date theory The result is not merely an enlightening read but a patently useful one, as the book prompts readers to examine our own practices and consider how we might apply the principles of high reliability in our own health systems What strikes me in reading this refreshingly global volume is the universality of many of the issues confronting leaders in healthcare Apollo astronaut Russell Schweikart once said that when you look down on earth from space, what strikes you is that it is all one system, with no actual borders or boundaries No matter where we live or practice medicine, the experience of providing—and receiving—healthcare has far more commonalities than differences While there certainly are variations across cultures, many of us are encountering comparable challenges today as we attempt to curb the cost of care while at the same time working to keep growing numbers of patients well We are all on this path together, and it is critical that we get it right We owe it to our patients and our fellow taxpayers (in the United States, healthcare expenditures have come to consume nearly 18% of our gross domestic product without a proportionate boost in outcomes), not to mention the next generation of medical professionals who will inherit the systems we are reshaping today So what, exactly, is our commitment to them? Above all, this book contends, we need to engineer systems that reliably deliver safe, high-quality care by monitoring our performance, providing transparent feedback, and continually improving Al Knawy et al define high-reliability organizations as those that achieve outstanding levels of safety and performance despite operating in high-risk environments Medicine is advancing at a more rapid pace than ever in human history, and as medicine becomes more complex more quickly, opportunities for error abound My Johns Hopkins colleague Dr Marty Makary, one of this book’s contributors, set off alarm bells in the field in 2016 with his finding that medical error is the third-leading cause of death in the United States Moreover, preventable errors cost the vii viii  ◾ Foreword United States tens of billions of dollars each year, costs for which insurance companies and other payers are increasingly reluctant to reimburse care providers Now more than ever, we have to bear down on the science of healthcare delivery For many years, patient-safety research was seen as the less-glamorous cousin to other types of scientific inquiry, but that is beginning to change For their part, Dr Makary and his co-authors here make a compelling case: “In a given year, more lives may be saved through the use of a procedure checklist than the number of lives saved by the newest chemotherapy.” Incremental improvements in care delivery may not garner as much hype as a sexy new pill or the discovery of a genetic marker of disease, but they can save many lives nonetheless Advances in safety science are not the only thing we have going for us as we work to ensure high reliability We also have powerful 21st-century tools at our disposal, with the electronic health record, mobile health apps, and other technologies As Hee Hwang points out in Chapter 6, “Advances in IT have provided new opportunities to pursue the triple aims of improving the patient care experience, improving the health of the population, and reducing per capita healthcare costs.” With petabytes of data capacity and muscular analytics, we are uniquely empowered to monitor our quality and efficiency and pinpoint areas for improvement This book sheds light on how to target those efforts to maximize reliability Despite our best efforts, we never will eliminate errors altogether As William Osler famously said, “The practice of medicine is an art, not a trade.” Along with the humanism that makes medicine so powerful—the physician’s intuition, the doctor–patient touch—comes the potential for human error That is why our organizations must “aim to be harm-free rather than error-free,” an important distinction laid out by Frank Federico and Hanan Edrees in Chapter In other words, we absolutely must take steps to minimize errors, but we also need to foster a culture where it is commonplace to discuss errors openly, not just in the name of accountability but in the interest of addressing issues early and learning from our mistakes While this book charts some promising routes on the path to high reliability in healthcare, most of us still have a considerable distance to travel as we implement change initiatives It is up to all of us to apply these ideas at home—and to share, far and wide, the lessons learned along the way—to arrive at a place where excellence is assured for each and every patient Paul B Rothman, MD Dean/CEO, Johns Hopkins Medicine Preface It seems that whatever the country, its politics, and its preferred healthcare system, leaders of the modern world face similar challenges to ensure never less than reliable standards of care for patients, their families, and their carers As a leader of one of the largest and most complex healthcare organizations in the Middle East, I recognize the need to equip managers, current and future, with the practical knowledge to build and sustain a reliable healthcare system While there are many publications concerning the theory behind the “ high reliability organization,”  few concentrate on real practical examples, their application, and their potential learnings This book aims to strike a balance between theory and practice, being descriptive, informative, and detailed, while encouraging and prompting the reader to explore his or her own thinking and practice Contributors have been carefully selected to represent various international healthcare systems with unique and pioneering characteristics All contributors understand the global and diverse nature of healthcare and are all frontline leaders of repute The concept of reliability has been used to describe a system with nearly harm-free care and one that delivers the same outcomes every single time, regardless of complexity or of the behavior of those who deliver and receive it This book looks to develop this definition, as it aims to provide healthcare leaders with the “ k now-how”  to build a reliable healthcare system covering key areas of quality and safe patient care The leaders of highly reliable healthcare systems must be able to design a structure to deliver consistently on all aspects of quality healthcare, whether it is timeliness, efficiency, safety, or culture Authoring, coordinating, and editing this book has been a journey that has lasted for almost one year It was one that filled me with excitement, learning, and hard work I would like to convey my thanks to all the contributors for their efforts It is my hope that Leading Reliable Healthcare  will add value and inspire healthcare managers and clinical leaders, responsible for shaping and delivering health systems, to improve the standard and quality of patient care across the world ix ... acid-free paper International Standard Book Number -13 : 978 -1- 138 -19 7 51- 0 (Hardback) International Standard Book Number -13 : 978 -1- 315 2-7758-5 (eBook) This book contains information obtained from... of T&F Informa plc.” | Includes index Identifiers: LCCN 2 017 0220 41| ISBN 97 811 3 819 7 510 (hardback : alk paper) | ISBN 97 813 15277585 (ebook) Subjects: LCSH: Medical errors Prevention | Medical... HOLTHOF 11 Leadership through Crisis .205 BANDAR AL KNAW Y v vi  ◾ Contents 12 Health System Innovation and Reform 217 TARA DONNELLY 13 The Financial Aspects of Leading a Reliable