The Institute of Medicine, Centers for Medicare and Medicaid, The Joint Commission, and other regulatory and accrediting bodies all agree that hospitals must be transformed into places where each patient receives quality care, every single time. In other words, zero defects. Helping to ensure quality at every level, high-reliability methods offer healthcare leaders the tools they need to achieve this noble goal.
Leading High-Reliability Organizations in Healthcare details the attributes and practices that help high-reliability organizations (HROs) excel in the service they provide to their customers. Explaining what it takes to achieve high reliability in healthcare settings, it defines reliability as much more than just being safe, it describes how to measure reliability and paves the way to higher reliability.
The book presents proven tools, concepts, and skills that leading healthcare organizations are using to improve safety and quality, including mistake proofing, Lean Six Sigma, and reliability engineering.
It details the roles and responsibilities of the two key organizational components involved in achieving high reliability: leadership and the reliability "engineers" who apply reliability methods both technically and socially throughout the healthcare value stream.
Rick Morrow, executive in HROs and now System Director of Quality, Safety, and Process Improvement at CHRISTUS Health, one of the largest non-profit healthcare systems, identifies the necessary infrastructure, methods, and analytics required to achieve and sustain higher reliability. He also suggests applications of high reliability concepts that have proven to work well in healthcare settings.
The book includes numerous case studies that illustrate success stories of healthcare organizations achieving higher reliability, some achieving zero defects for years. It also contains case studies that examine examples of failures, so you can avoid making the same mistakes.
Table of Contents
Reliability – Able to Rely
Leadership and Engineering Reliability
Reliability Is about Clinical Outcomes
Measures of Reliability
Common Measures of Reliability
Mean Time to Failure and Mean Time between Failures
Reliability Enhanced without Compromise
Probability Measures of Reliability
Data Characteristics in Reliability Analysis
Leadership Principles in High Reliability Organizations (HROs)
Reliability Begins with Design
Malcolm Baldrige National Quality Award and Reliability
Culture of High Reliability Organizations
Principles Common among HROs
Elements of an HRO
Management Principles in HROs
Practice Makes More Reliable
Standardized Work History
Healthcare Leaders in Practice
Visual Management of and for Reliability
Leading Change with Training Within Industry (TWI)
Achieving High Reliability in Functional Outcomes
Reliability Begins with Truth in Measurement
Patient Experience Improved Reliability
Pay-for-Quality vs. Fee-for-Service Drives Reliability
Achieving Higher Reliability in Safety Outcomes
A Texas-Based Healthcare System on the HRO Journey
Achieving 100% Reliability Case Study
The Roadmap to High Reliability
Robust Process Improvement at The Joint Commission and Center for Transforming Healthcare
High Reliability Roadmap that Works
History of Healthcare Reliability
W. Edwards Deming
Reliability and Six Sigma – An Interview with Mikel Harry – Co-Founder of Six Sigma
Healthcare Reliability Promoted
Capability: The Precursor to Reliability
Process Control and Capability
Capability Case Study
Performing Capability Analyses
Three Capability Measures
Bilateral and Unilateral Tolerances
Six Steps to Calculate and Analyze Capability
Kicking a Goal and Capability the Concept
Minitab’s Assistant Feature in Capability Analysis
Design for Reliability
Unifying Instructive Force
Pre-Production Part Approval
Advanced Product/Service Quality Planning
Failure Mode and Effects Analysis (FMEA) Case Studies
Healthcare Clinical Standards and Conditions of Participation in Reliability Design
Rolled Throughput Yield (RTY)
Inspection Is Not Reliable
Total Knee and Hip Replacement and Reliability
Defects and Abnormalities
Theory of Escaping Defects
Checklists in Healthcare
Graphical and Statistical Methods for Reliability
Statistical Process Control (SPC)
Infrequent Event SPC Charting
Cost of Poor Quality
Value Streams in Accountable Care Organizations
Rick Morrow is a consultant with more than 25 years of senior leadership experience in the healthcare, aviation, construction, automotive, and high tech industries. Morrow leads the quality, safety, and high reliability unit of Healthcare Performance Partners, a MedAssets company. He has authored Lean Six Sigma performance excellence courses and taught and deployed programs internationally for Eaton Corporation, SKF, Motorola, United Airlines, The Joint Commission, and Healthcare Performance Partners.
Morrow is the author and leader of HPP’s Six Sigma consulting. He wrote and leads the Belmont University Lean Healthcare Certification Program for Supply Chain Professionals, which is a blend of The Toyota Production System, Six Sigma, and Change Leadership. Morrow also wrote and taught The University of Pennsylvania’s Penn Medicine Leadership and Performance Improvement courses. He authored the Lean Six Sigma Program at The Joint Commission and steered its Center for Transforming Healthcare, where he and his team led collaborations improving patient care and safety with major academic medical centers including Cedars-Sinai, Johns Hopkins, Mayo Clinic, Intermountain Healthcare, North Shore Long Island Jewish, and Stanford University.
"Working with Rick Morrow for two years, I know that he puts into practice what he writes in this book. The evidence from successful hospital departments in reliability shows what his teachings will do to move your hospital continually in the positive direction."
-Elizabeth Gentry, Ph.D., Assistant Professor, Director, Online Masters in Eng. Mgmt., Department of Industrial Engineering, University of Louisville