Becoming a High Reliability Organization: Part 2

Establishing and Maintaining a Culture of Safety

Becoming a High Reliability Organization: Establishing and Maintaining a Culture of

Safety

Sustainable change

CRP

Establishing and Maintaining a Culture of Safety• Define Safety Culture and associated concepts• Evaluate HRO “best practices” for consistent

performance• Identify key elements of leadership for

improving CRP performance • Discuss strategies for holding onto the gains

SAFETY CULTURE is the enduring value and priority placed safety by everyone in

every group at every level of an organization.

Safety Culture Working Definition

Understanding & Managing Safety Culture• Culture is not steady-state, it moves• For the most part, the movement is predictable and

manageable• There is a cultural pendulum in most organizations• ‘Situational Awareness’ of cultural trends is key for

management

Safety Culture Working Definition

So why is there so much emphasis on creating a

culture of safety?

Sir Liam Donaldson, CMO NHS UK

“When a person gets on an airplane, their chances of dying are one in 10,000,000.

When a person is admitted to a hospital, the risk of dying or being seriously injured by medical error is one in 300”.

Background

Remember: Key Characteristics of HROs• Low error tolerance and high accountability• Preoccupation with failures• Broad knowledge base and situational

awareness• Resiliency: HROs bounce back fully plus• Perceive accurate links between cause and

effect• Consistency of purpose and excellence

We have to “standardize,” so that we achieve consistently excellent performance of our staff in the facility.

Courtesy Tillman Gabriel

Rules

Law Policies

Procedures

Getting Your Team Commitment

• Apple pie rationale• Protect employees and families

• Protect customer and public

• Accidents can put you out of business

• Stigma of ANY adverse event

• Safety is a competitive advantage

• Establish norms or agreed standards of acceptable and unacceptable conduct

• Set clear priorities and a framework for how the team will operate

• Emphasize safety, communication and cooperation

Team Leadership

• In charge of their team and their facility

• Exercise role and responsibility with an appropriate amount of authority

• Effectively match experience and competence of the team to requirements of task and clinical situation

Effective Leaders

“The Balance”

• Do they seem detached?

• Are their any hidden agendas?

• Are any members of the team fatigued, angry, frustrated or distracted?

Effective Leaders: Understand their Teams

“The very essence of leadership is that you have a vision…a vision you articulate clearly and forcefully on every occasion.”

-Theodore Hesburgh, President, University of Notre Dame

Leadership Vision

Power and Leadership

Leadership power is much more than the use of force...it is influencing others to truly WANT to achieve a goal

• Being the manager gives you the authority to accomplish the task and authority in the organization

• It does not make you a leader...it simply makes you the boss

• Leadership makes people want to achieve high goals and objectives…bosses tell people to accomplish a task or objective

Power and Leadership

Strategies

Implementation Keys

• Outline critical steps in to ensure they are completed on time

• Identify and react to barriers that might effect team’s success

• Establish specific courses-of-action for sustainable wins

• Identify, evaluate, and implement measurement systems for tracking progress

Your customer

• Included

• Informed

• Engaged

• Enticed

• Encouraged

• Completely Satisfied

What Does Management Commitment Really Mean?• Incorporating incentives (or disincentives) into staff

performance evaluations

• Defining, and establishing in writing, goals for the organization in terms of performance expectations, time allotted, resources available, and evaluation

• Review goals regularly with staff and customers as often as practicable

• Show your staff and that this is an organizational imperative rather than saying that it’s theirs

Team Involvement Strategies

• Develop ownership - bring multi-level team in on the decision making and planning process

• Enable individual success, while maintaining the well-being and stability of the team

• Engage individuals in achieving team objectives • Give team authority to get things accomplished in

the most efficient and timely manner

Key Elements of Implementing a Cultural Change• Manage the number of initiatives

• Train, then measure, evaluate, retrain, reevaluate, repeat

• Drive to completion, then spread exponentially

• Undertake new projects as initiatives are completed,

standardizing everything possible enroute

• Don’t declare “completion” prematurely

Why do all of these things when you’re already so busy?

• It’s in everyone’s best interest

• We can’t afford not to do it

Spence ByrumManaging PartnerConvergent HRS, LLCsbyrum@convergenthrs.com(901) 337-5796www.convergenthrs.com

Session Evaluation Information

SESSION TITLE: High-Rel2

SESSION CODE: L-T1045