Building a High-Reliability Organization: A Toolkit for Success Gary Sculli, RN, MSN, ATP Douglas E. Paull, MD, FACS, FCCP, CHSE Building a High-Reliability Organization: A Toolkit for Success is a practical guide to becoming a high-reliability organization (HRO). HROs practice the highest standards of patient quality and prevent never events before they occur. In this first-of-its-kind book, written for real-world healthcare professionals on the front lines of patient safety, authors Gary L. Sculli, RN, MSN, ATP, and Douglas E. Paull, MD, FACS, FCCP, CHSE, take the concept of an HRO and break down what it means at the point of care. Through step-by-step instructions and a practical, straightforward approach, they demonstrate how your organization can ensure safe patient care, every day, for every patient. After reading this book, you will: Possess a clear understanding of what constitutes high-reliability healthcare Be able to promote evidence-based, reliable methods to improve safety, including team training, fatigue management systems, and investment in patient safety infrastructure and technology Understand which elements and behaviors must be included in an overall plan to achieve high reliability at the front lines of care Become a transformational leader in your healthcare organization Be able to apply the principles of a fair and just culture to promote the reporting, discussion, and disclosure of adverse events Table of Contents: Preface and Precepts Chapter 1: Situational Awareness Is Fundamental to High Reliability Chapter 2: Situational Awareness Countermeasures Chapter 3: Everyone on the Same Sheet of Music Chapter 4: Yes--You Need to Use the Checklist! Chapter 5: Preoccupation With Failure--It's an Attitude Chapter 6: Recognizing That the Expert Is Not Always the Person in Charge Chapter 7: Lab Coats and Scrubs, Meet Suits and Ties--Sensitivity to Frontline Operations Chapter 8: Just Response to Human Error: A Necessary Component of High-Reliability Organizations Chapter 9: Standardize Communication and Processes to Create Equivalent Actors Chapter 10: Ensuring Technical and Non-Technical Competence

Since the first edition of Managing the Unexpected was published in 2001, the unexpected has become a growing part of our everyday lives. The unexpected is often dramatic, as with hurricanes or terrorist attacks. But the unexpected can also come in more subtle forms, such as a small organizational lapse that leads to a major blunder, or an unexamined assumption that costs lives in a crisis. Why are some organizations better able than others to maintain function and structure in the face of unanticipated change? Authors Karl Weick and Kathleen Sutcliffe answer this question by pointing to high reliability organizations (HROs), such as emergency rooms in hospitals, flight operations of aircraft carriers, and firefighting units, as models to follow. These organizations have developed ways of acting and styles of learning that enable them to manage the unexpected better than other organizations. Thoroughly revised and updated, the second edition of the groundbreaking book Managing the Unexpected uses HROs as a template for any institution that wants to better organize for high reliability.

THE NAVY'S SILENT WARRIORS LIVE AND BREATHE OPERATIONAL EXCELLENCE. How does a group of 130 men with an average age of 25 operate a nuclear power plant in the ocean's harshest environments while conducting complex clandestine operations aboard a 6900-ton warship with nearly flawless results? The answer lies in the community's culture which epitomizes the tireless pursuit of Operational Excellence. Applying the US Nuclear Submarine Culture to Your Organization Operational Excellence is a journey, not a destination. Let Matt and Bob give you a tour of the Navy's Silent Warriors' commitment to this journey that began nearly seven decades ago. DISCOVER: How to create a culture of intellectual integrity and the pursuit of knowledge. How to engage employees through procedural compliance and standards. How to foster an environment that fully leverages the talent of each individual. How to strengthen an organization by thoroughly evaluating mistakes. How to lead an organization to Operational Excellence from any starting point.

Increasingly, scholars view reliability—the ability to plan for and withstand disaster—as a social construction. However, there is a tendency to evoke this concept only in the face of catastrophes, such as the British Petroleum oil spill or the Space Shuttle Challenger explosion. This book frames reliability as a fundamental issue in the study of organizations—one that can also improve day-to-day operations. Bringing together a diverse cast of contributors, it considers how we can account for the ability of some organizations to maintain high reliability and what we can learn from them. The chapters distinguish reliability from related lines of inquiry; take stock of relevant research from different disciplinary perspectives; highlight implications for practice; and identify directions, questions, and priorities for future research. The first of its kind in over twenty years, this volume delivers a dynamic base of shared knowledge and an integrative research agenda at a time when organizational reliability has never been so important.

Improve your company's ability to avoid or manage crises Managing the Unexpected, Third Edition is a thoroughly revised text that offers an updated look at the groundbreaking ideas explored in the first and second editions. Revised to reflect events emblematic of the unique challenges that organizations have faced in recent years, including bank failures, intelligence failures, quality failures, and other organizational misfortunes, often sparked by organizational actions, this critical book focuses on why some organizations are better able to sustain high performance in the face of unanticipated change. High reliability organizations (HROs), including commercial aviation, emergency rooms, aircraft carrier flight operations, and firefighting units, are looked to as models of exceptional organizational preparedness. This essential text explains the development of unexpected events and guides you in improving your organization for more reliable performance. "Expect the unexpected" is a popular mantra for a reason: it's rooted in experience. Since the dawn of civilization, organizations have been rocked by natural disasters, civil unrest, international conflict, and other unexpected crises that impact their ability to function. Understanding how to maintain function when catastrophe strikes is key to keeping your organization afloat. Explore the many different kinds of unexpected events that your organization may face Consider updated case studies and research Discuss how highly reliable organizations are able to maintain control during unexpected events Discover tactics that may bolster your organization's ability to face the unexpected with confidence Managing the Unexpected, Third Edition offers updated, valuable content to professionals who want to strengthen the preparedness of their organizations—and confidently face unexpected challenges.

Each year, more than 200,000 patients die as a result of medical errors--the third leading cause of death in the United States. Although the numbers are staggering and the challenges great, this national healthcare crisis is solvable--and fixing it has become a personal mission for John Byrnes, MD, and Susan Teman, RN. Byrnes and Teman have a proven track record in helping hospitals and health systems transform into high-reliability organizations that aim to deliver error-free care at an affordable cost. In The Safety Playbook: A Healthcare Leader's Guide to Building a High-Reliability Organization, they lay out their process for building a safety program that can eradicate preventable medical errors. Written in a clear, conversational style, the book applies to all types of healthcare organizations and speaks to leaders across the spectrum--from board members and C-suite executives to clinical leaders; managers; and staff of quality, safety, and risk management departments. Readers of The Safety Playbook will: - Review the current rate of medical errors and explore proven solutions, including high reliability - Discover how transparency about errors and their causes makes a successful safety program possible - Learn how developing internal safety experts saves time and money - Examine safety tools and practices used effectively in high-reliability industries - Understand why communication is the top cause of medical errors and how to improve it - Explore guidelines used in other healthcare organizations that create a culture of safety - Study a sample project plan and timeline for implementing a safety program Filled with compelling case studies and practical tools and strategies, this groundbreaking book can be a catalyst for transforming an organization's culture, delivering safer care to patients, and ultimately saving lives. The American College of Healthcare Executives and the Institute for Healthcare Improvement/National Patient Safety Foundation's Lucian Leape Institute (IHI/NPSF LLI) have partnered to collaborate with some of the most progressive healthcare organizations and globally renowned experts in leadership, safety, and culture to develop Leading a Culture of Safety: A Blueprint for Success. This document is an evidence-based, practical resource with tools and proven strategies to help senior leaders in healthcare create a culture of safety--an essential foundation for achieving zero harm. The guide, freely downloadable from the IHI/NPSF website, is an excellent complement to The Safety Playbook. With both high-level strategies and practical tactics, the guide can be used to help determine the current state of an organization's journey, inform dialogue with its board and leadership team, and help its leaders set priorities. Whether an organization is just beginning the journey to a culture of safety or is working to sustain its safety culture, Leading a Culture of Safety can serve as a useful guide for directing efforts and evaluating an organizati

Building on the revolutionary Institute of Medicine reports To Err is Human and Crossing the Quality Chasm, Keeping Patients Safe lays out guidelines for improving patient safety by changing nurses' working conditions and demands. Licensed nurses and unlicensed nursing assistants are critical participants in our national effort to protect patients from health care errors. The nature of the activities nurses typically perform â€" monitoring patients, educating home caretakers, performing treatments, and rescuing patients who are in crisis â€" provides an indispensable resource in detecting and remedying error-producing defects in the U.S. health care system. During the past two decades, substantial changes have been made in the organization and delivery of health care â€" and consequently in the job description and work environment of nurses. As patients are increasingly cared for as outpatients, nurses in hospitals and nursing homes deal with greater severity of illness. Problems in management practices, employee deployment, work and workspace design, and the basic safety culture of health care organizations place patients at further risk. This newest edition in the groundbreaking Institute of Medicine Quality Chasm series discusses the key aspects of the work environment for nurses and reviews the potential improvements in working conditions that are likely to have an impact on patient safety.

Experts estimate that as many as 98,000 people die in any given year from medical errors that occur in hospitals. That's more than die from motor vehicle accidents, breast cancer, or AIDSâ€"three causes that receive far more public attention. Indeed, more people die annually from medication errors than from workplace injuries. Add the financial cost to the human tragedy, and medical error easily rises to the top ranks of urgent, widespread public problems. To Err Is Human breaks the silence that has surrounded medical errors and their consequenceâ€"but not by pointing fingers at caring health care professionals who make honest mistakes. After all, to err is human. Instead, this book sets forth a national agendaâ€"with state and local implicationsâ€"for reducing medical errors and improving patient safety through the design of a safer health system. This volume reveals the often startling statistics of medical error and the disparity between the incidence of error and public perception of it, given many patients' expectations that the medical profession always performs perfectly. A careful examination is made of how the surrounding forces of legislation, regulation, and market activity influence the quality of care provided by health care organizations and then looks at their handling of medical mistakes. Using a detailed case study, the book reviews the current understanding of why these mistakes happen. A key theme is that legitimate liability concerns discourage reporting of errorsâ€"which begs the question, "How can we learn from our mistakes?" Balancing regulatory versus market-based initiatives and public versus private efforts, the Institute of Medicine presents wide-ranging recommendations for improving patient safety, in the areas of leadership, improved data collection and analysis, and development of effective systems at the level of direct patient care. To Err Is Human asserts that the problem is not bad people in health careâ€"it is that good people are working in bad systems that need to be made safer. Comprehensive and straightforward, this book offers a clear prescription for raising the level of patient safety in American health care. It also explains how patients themselves can influence the quality of care that they receive once they check into the hospital. This book will be vitally important to federal, state, and local health policy makers and regulators, health professional licensing officials, hospital administrators, medical educators and students, health caregivers, health journalists, patient advocatesâ€"as well as patients themselves. First in a series of publications from the Quality of Health Care in America, a project initiated by the Institute of Medicine

An authoritative survey of different contexts, methodologies, and theories of applied communication The field of Applied Communication Research (ACR) has made substantial progress over the past five decades in studying communication problems, and in making contributions to help solve them. Changes in society, human relationships, climate and the environment, and digital media have presented myriad contexts in which to apply communication theory. The Handbook of Applied Communication Research addresses a wide array of contemporary communication issues, their research implications in various contexts, and the challenges and opportunities for using communication to manage problems. This innovative work brings together the diverse perspectives of a team of notable international scholars from across disciplines. The Handbook of Applied Communication Research includes discussion and analysis spread across two comprehensive volumes. Volume one introduces ACR, explores what is possible in the field, and examines theoretical perspectives, organizational communication, risk and crisis communication, and media, data, design, and technology. The second volume focuses on real-world communication topics such as health and education communication, legal, ethical, and policy issues, and volunteerism, social justice, and communication activism. Each chapter addresses a specific issue or concern, and discusses the choices faced by participants in the communication process. This important contribution to communication research: Explores how various communication contexts are best approached Addresses balancing scientific findings with social and cultural issues Discusses how and to what extent media can mitigate the effects of adverse events Features original findings from ongoing research programs and original communication models and frameworks Presents the best available research and insights on where current research and best practices should move in the future A major addition to the body of knowledge in the field, The Handbook of Applied Communication Research is an invaluable work for advanced undergraduate students, graduate students, and scholars.