Assignment:
Part 1
Culture drives quality-if an organization does not have a culture in which they hold themselves and others accountable, it is probable that it will not achieve and sustain high-level quality outcomes. Patient safety is defined as freedom from accidental injury; you have seen how medical errors are harmful, and that there are second victims that suffer as well. Remember quality can be defined as "the cumulative impact of all that happens to a patient while in an organization's care" (Porter, 2012, p. 193).
A Just Culture gives organizations a template to uniformly address the shortcomings or errors of those who fail. It addresses failures in four different areas, which include 1) human errors and mistakes, meaning unintentional harm; 2) carelessness or at-risk behavior-or not paying attention that results in an error; 3) recklessness or a flagrant disregard for norms where an error occurs unintentionally, but because of recklessness; and 4) those who just do not pay attention and have no regard for authority.
In this Discussion, you will identify a model that a health care organization might use to improve their culture of quality and describe whether the ethical theory of Just Culture would improve the quality and why.
Joshi, M. S., Ransom, E. R., Nash, D. B., & Ransom, S. B. (Eds.). (2014). The healthcare quality book: Vision, strategy, and tools (3rd ed.). Chicago, IL: Health Administration Press.
Detsky, A. S., Baerlocher, M. O., & Wu, A. W. (2013). Admitting mistakes: Ethics says yes, instinct says no. Canadian Medical Association Journal, 185(5), 448.
MacLeod, L. (2014). "Second Victim" casualties and how physician leaders can help. Physician Executive, 40(1), 8-12.
Nelson, W. A. (2013). Addressing the second victims of medical error. Healthcare Executive, 28(2), 56-59.
Part 2
You can decrease the frequency of any behavior through punishment, but why not give some thought to reciprocal inhibition? Reciprocal inhibition is the process of defining the opposite of the undesirable behavior and reinforcing the positive instead. Reciprocal inhibition can be useful for leaders in helping change behaviors aiming for high reliability. For example, instead of punishing errors, reward quality.
In this Assignment you will identify where reciprocal inhibition might be used to improve patient outcomes in quality and patient safety. You will also recommend steps that will foster a culture of quality and recommend at least one strategy for overcoming the challenges of achieving a culture of high reliability.
To prepare:
Review this Week's Learning Resources related to creating a culture of high reliability
The Assignment:
This reading suggests that reciprocal inhibition is a good strategy to change reinforcers in the health care system and that "culture eats strategy."
Considering your organization, or a health care organization you are familiar with, write a 3 to 4 page paper that:
• Describes how and where reciprocal inhibition might be used to improve patient outcomes in quality and improve patient safety.
• Explains how using reciprocal inhibition may be an improvement in the culture of quality. Include any steps that will foster a culture of quality in an organization to become a high-reliability organization.
• Recommend at least one strategy for overcoming the challenges of fostering a culture of high reliability.
Joshi, M. S., Ransom, E. R., Nash, D. B., & Ransom, S. B. (Eds.). (2014). The healthcare quality book: Vision, strategy, and tools (3rd ed.). Chicago, IL: Health Administration
Edwards, M. T. (2013). A longitudinal study of clinical peer review's impact on quality and safety in U.S. hospitals. Journal of Healthcare Management, 58(5), 369-385.
Grintsova, O., Maier, W., &Mielck, A. (2014). Inequalities in health care among patients with type 2 diabetes by individual socio-economic status (SES) and regional deprivation: A systematic literature review. International Journal for Equity in Health, 13, 43.
Hall, W. J., Chapman, M. V., Lee, K. M., Merino, Y. M., Thomas, T. W., Payne, B. K., ... Coyne-Beasley, T. (2015). Implicit racial/ethnic bias among health care professionals and its influence on health care outcomes: A systematic review. American Journal of Public Health, 105(12), e60-e76.