High Reliability Culture

Creating a Culture of High Reliability

The MHA Keystone Center is dedicated to educating and improving workplace culture in member hospitals. We encourage hospitals to adopt a strong cultural stance on safety by emphasizing the importance of improvement at the organizational and unit level. This includes embracing a safety-oriented philosophy that is reflected in our mission statement, vision and organizational goals. As one of our foundational concepts, the MHA Keystone Center recognizes the importance culture improvement plays in achieving safer workplaces for employees, patients and better healthcare for our communities.

Learn more about the MHA Keystone Center’s culture improvement efforts.

Launched in March 2016, the MHA Keystone Center Speak-up! Award is designed to acknowledge the efforts of individuals or teams within MHA Keystone Center Patient Safety Organization (PSO) hospitals who speak up to prevent potential harm to patients or other staff members. The award represents a volitional voicing of concerns by one or more people and is a tool to help eliminate preventable harm caused by miscommunication and non-communication. The MHA Keystone Center Speak-up Award is an adaptation of the Minnesota Hospital Association’s Good Catch for Patient Safety Award. Learn more about the MHA Keystone Center Speak-up! Award on our Awards page.

The MHA Keystone Center uses the John Hopkins Armstrong Institute for Patient Safety and Quality and the Agency for Healthcare Research and Quality’s Comprehensive Unit-based Safety Program (CUSP) to drive culture change in member hospitals. CUSP is designed to educate and improve awareness about safety and quality of care. This program empowers staff to take charge and improve safety in the workplace, while creating partnerships between units and hospital executives to improve organizational culture. Additionally, the CUSP framework helps units to better leverage resources for improvement efforts and provide tools to investigate and learn from defects. The unit-based safety team uses a structured process while deferring to the local wisdom and insight of front-line staff who prevent safety hazards every day (AHRQ, 2011).

Learn more about CUSP in this video.

Member hospitals can learn more about our cultural improvement efforts and access resources on the MHA Community site.

Source: AHRQ (2011). Using a Comprehensive Unit-based Safety Program to Prevent Healthcare-Associated Infections. 

Duplicative survey efforts in most hospitals continue to create cost burden, survey fatigue and isolated datasets that do not produce a comprehensive snapshot of the factors driving hospital performance. The need has never been more acute for survey integration and also for a more refined and specific survey instrument that clearly links measurement to improvement.

The Safety, Communication, Operational Reliability and Engagement (SCORE) survey yields valuable information about unit culture and employee engagement in organizations, and the results can be used to drive positive change. Data from the survey is used to monitor progress for those hospitals participating in the MHA Keystone Center high reliability initiative.

SCORE survey domains that are tested include:

  • Learning environment
  • Local leadership
  • Burnout climate and resilience
  • Teamwork climate
  • Safety climate
  • Engagement
  • Work/life balance

More information on the SCORE survey is available for members on the MHA Community site.

For more information, contact the MHA Keystone Center PSO.