High Reliability Organizations
A high reliability organization (HRO) achieves top outcomes despite operating in complex or high-risk environments.
The airline and nuclear industries are common examples of HROs. They get top results by:
- Standardizing processes for less variability
- Reducing errors to achieve zero harm in clinical and non-clinical areas
- Celebrating transparency and accountability
- Valuing everyone's input, regardless of rank
After a review of MHS performance in 2014, each service medical department and the DHA took specific action to improve health care access, quality, safety, transparency, and patient engagement. Now the DHA is working to standardize and spread these efforts, in a coordinated path to high reliability for the entire MHS: Ready Reliable Care.
Ready Reliable Care Principles
The seven principles of Ready Reliable Care guide our work and apply to all staff, in every job. When we use these principles in our work, we advance high reliability:
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PREOCCUPATION WITH FAILURE
Drive zero harm by anticipating and addressing risks
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SENSITIVITY TO OPERATIONS
Be mindful of how people, processes, and systems impact outcomes
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DEFERENCE TO EXPERTISE
Seek guidance from those with the most relevant knowledge and experience
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RESPECT FOR PEOPLE
Foster mutual trust and respect
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COMMITMENT TO RESILIENCE
Leverage Past mistake to learn, grow, and improve processes
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CONSTANCY OF PURPOSE
Persist through adversity towards the common goal of zero harm
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RELUCTANCE TO SIMPLIFY
Strive to understand complexities and address root causes
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Ready Reliable Care Domains of Change
By using the Ready Reliable Care principles in our daily work, all staff contribute to a more ready and reliable MHS. System-wide progress happens across four domains of change:
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LEADERSHIP COMMITMENT
Prioritize Ready Reliable Care at all levels of leadership
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CULTURE OF SAFETY
Commit to safety and harm prevention
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CONTINUOUS PROCESS IMPROVEMENT
Advance innovative solutions and spread leading practices
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PATIENT CENTEREDNESS
Focus on patients' safety and quality of care experience
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Do you know someone who is contributing to a more highly reliable MHS and advancing the DHA mission by embodying Ready Reliable Care principles in their daily work? Nominate them, as part of the DHA Director Spotlight recognition program.
Clinical Improvement Priorities for Military Hospital and Clinic Providers
Ready Reliable Care efforts span all four domains of change noted above. This year, we are focused on several projects to support continuous process improvement in the clinical care setting. They include:
- Stepped Care Model for Pain: This model will allow military hospitals and clinics to standardize and effectively implement evidence-based best practices for managing acute and chronic pain in the primary care setting.
- Opioid Overdose / Naloxone Distribution: Through standardized management of chronic pain, this program will ensure that patients taking long-term opioid therapy with an elevated risk of opioid-related harm, receive overdose education and at least one prescription for naloxone medication in a 12-month window.
For other clinical priorities, visit the page for clinical improvement priorities for military hospital and clinic providers