Pullman Regional Hospital’s Journey to a High Reliability Organization (HRO)
Pullman Regional Hospital, a critical access hospital in Pullman, Washington, has demonstrated its commitment to a high-reliability organization that aligns and integrates systems of safety, clinical practice, quality and risk management, human resources, finance, and operational performance improvement.
Pullman Regional uses a Just Culture Screening Tool that assists in determining human error, at-risk, and reckless choices. When a staff member makes a mistake, the team focuses on learning, not blaming individuals. As a result, non-punitive response to errors has increased from 50% in 2011 to 79% in 2022.
Building a High Reliability Program from 2020 – 2022 included:
- Developed a High Reliability Team
- Melded the vision of the Collaborative High Reliability Program and integrated it with DNV’s International Organization for Standardization (ISO) standards and certification
- Received Board of Commissioner approval in 2021 through the Quality Management System Committee for the -establishment of a Collaborative High Reliability Program
- Hired a Chief Reliability Officer in 2022
- DNV Beta Survey in February 2022 for Collaborative High Reliability/Reliability Management Team (RMT)
Key learnings along the way included:
- Alignment of policies to integrate across the organization, i.e., HR policies and Employee Handbook, Code of Conduct, Compliance, Quality Management, Risk/Safety plans, Performance Improvement, and Labor Union contracts (invited to participate)
- Wording, definitions, and concepts have to be the same throughout
- Confidential risk reporting available to all employees
The benefits of a High Reliability approach include a collaborative 360º risk perspective, giving staff a voice, engaging staff in the process, and connecting staff to the work of the organizational metrics.
As a result of the organizational commitment, qualification certificates for the Collaborative Just Culture Program and Reliability Management Team were awarded in January 2023. Pullman Regional Hospital is the first Critical Access Hospital to receive this DNV qualification. Congratulations!
To learn more about high reliability in health care, see the slides and recording from Spreading Bundle Tools and Resources on High Reliability Culture, a full-day virtual event recorded on Dec. 7, 2023, with Healthcare Quality Improvement Contractor (HQIC) subject matter experts and hospital teams sharing their journeys to high reliable care. https://qioprogram.org/events/spreading-bundle-tools-and-resources-high-reliability-culture