Hospital Spotlight: St. Joseph Mercy Oakland Embarks on High Reliability Journey
Posted on June 06, 2019
High reliability is a perpetual buzzword and hot topic in healthcare. However, the substantial changes and hard work required to become highly reliable is often not appreciated.
Healthcare organizations must be firmly committed to continuous improvement, make huge strides in employee engagement, focus on safety culture and have the utmost leadership support. Hospitals also need to understand that high reliability and attaining zero preventable harm does not occur overnight. It is an ever-present and ever-changing journey that requires careful planning and execution, persistence and collaboration organization-wide.
Three years ago, the MHA Keystone Center started its relationship with the Joint Commission Center for Transforming Healthcare (CTH). As part of the arrangement, the MHA Keystone Center asked some of its member hospitals to embark on a high reliability journey.
Pontiac-based St. Joseph Mercy Oakland, a member of Trinity Health, was among the first hospitals to commit to the work. The 443-bed hospital, led by President Shannon Striebich, believed that the term ‘high reliability’ resonated with its overall mission, vision and values.
In its initial steps, St. Joseph Mercy Oakland completed The Joint Commission’s Oro® 2.0 Organizational Assessment, which allows organizations to see where they fall on the high reliability spectrum. The results allowed its executive leadership team to create plans for culture change and determine tangible quality and safety work that would make those plans a reality.
Trust and communication were initially identified as areas of organizational opportunity that leadership needed to champion. A workplan was developed that included executive leadership rounds, engagement and visibility. The MHA Keystone Center and CTH provided monthly calls and regularly scheduled site visits for all participating hospitals, which allowed for robust discussions on ways to advance progress and peer-to-peer support.
Healthcare is complex and highly dependent on human behavior. While providers have implemented processes and policies to prevent errors, they can and still happen. Striebich believes the only way to solve that issue and work toward zero harm is to openly discuss successes and failures and drill down on the things that did not go right to prevent them from happening again. She believes in being hard on the process, not on the people, and that engaging those closest to the work leads to positive, sustainable change.
The term zero preventable harm can be intimidating and slightly overwhelming. However, Striebich said that focusing on the impacts of avoidable harm, such as hospital acquired infections, allowed the entire organization to set smaller, more realistic goals, while working toward the bigger picture. Central Line-associated Bloodstream Infections (CLABSI) was one of the first areas the hospital opted to tackle.
The MHA Keystone Center and CTH partnership concluded in December 2018. At that time, St. Joseph Mercy Oakland had not experienced a CLABSI in two years, and in at or better than top decile performance on other key quality indicators. For the past three years and counting, St. Joe's has earned an "A" in the Leapfrog Group's Hospital Safety Grades.
Change starts with culture, Striebich said, and in the annual Culture of Safety and Engagement surveys, both colleagues and the medical staff scores have improved significantly over the past two survey periods. St. Joseph Mercy Oakland was not only the most improved hospital among all Trinity Health facilities, it's also among the best for promoting a culture of safety. It started with leadership's commitment to high reliability.
The hospital has also set more aggressive targets to improve in various areas, maintains its awareness of what is and isn’t working, and keeps safety as its top priority.
This article was featured in the MHA Keystone Center Newsletter. To subscribe, please contact Ashley Sandborn, MHA Keystone Center communications specialist.
Posted in: Patient Safety & Quality