On Wednesday March 15, 2017, around 50 faculty, staff, students and healthcare providers from the University of Washington (UW) and UW Medical Center (UWMC) attended the Leadership Workshop What Makes an Organization Highly Reliable. Guest speaker Dr. Tim Vogus, PhD, Associate Professor of Management and Faculty Director for Leadership Development Program at Vanderbilt University, kicked off part one of the workshop with a 40-min presentation describing key aspects of highly reliable organizations (HRO) Part two transitioned to a two-hour, interactive team work session for the UWMC cardiology units and UW Regional Heart Center (RHC) outpatient clinic. The Leadership Workshop is part of a quarterly professional and team development series funded by the Advanced Heart Failure Interprofessional Collaborative Practice (AHF-IPCP) grant through the Health Resources and Services Administation (HRSA); lead by Professor Brenda Zierler (UW School of Nursing), and in collaboration with the UW Center for Health Sciences Interprofessional Education, Research and Practice (CHSIE).
To be a HRO, Dr. Vogus recommends that organizations focus on creating a culture of safety and standardize care according to best practice. Organizations should: continuously anticipate and learn from errors; question and adapt everyday activities; have employees learn from each other and collaborate to best use expertise; coach, empower, and train others; and hire for interpersonal skills.
For the last three years, the Leadership Workshops and work of the AHF-IPCP grant has been collaborating with heart failure care teams to make their work more highly reliable with the implementation of team-based bedside rounds in the UWMC inpatient heart failure units. In collaboration with the AHF-IPCP grant, this grassroots initiative was designed by an interprofessional “Change Team” at UWMC and implemented in the Critical Care Unit (August 2015) and Telemetry Unit (March 2016). In the breakout session with Dr. Vogus, the inpatient Change Team and UWMC leadership reflected upon how their work over the last three years has helped to make their units HROs. While the Change Teams will continue to adjust the SIBR process as needed, they are shifting their focus to making their work sustainable after the AHF-IPCP grant ends in June 2017. Additionally, the Change Teams are continuing to learn from other heart failure units at UWMC and working to best align their care with other units at UWMC.
The RHC’s Change Team also reflected upon their work to make the outpatient clinic a HRO during the breakout session with Dr. Vogus. Some of their accomplishments over the last year are increasing awareness of healthcare team members’ roles, developing staffing sheets and reference binders, and utilizing morning briefs and huddles to organize workload and schedules. While these processes are creating a culture of safety, the outpatient Change Team is hoping to standardize some more processes according to best practice with their future work.