WACH’s journey to becoming a High Reliability Organization

FORT IRWIN, Calif. — The Joint Commission Center for Transforming Healthcare conducted a staff assisted visit for key leaders at Weed Army Community Hospital. The purpose of the visit was to provide strategic guidance for the development of a road map to becoming a high reliability organization starting with a culture of safety self-assessment on Sept. 12-13.

“It was an all-encompassing event not focusing on just leadership. We did interviews with staff members of the hospital to get truthful feedback of what they thought about the culture in their departments,” said Maj. Samantha Hanson, Chief of Quality Services at Weed Army Community Hospital.

Being a High Reliability Organization is a concept familiar throughout the U.S. Army’s Medical Command. It is a journey that leadership at WACH are focused on undertaking with great passion and commitment.

The goal is to ensure that ZERO harm of any kind, whether it be to patients, staff, or visitors is a guiding principle behind any military medical command. WACH leaders took into consideration how to incorporate this concept without altering the mission at Weed Army Community Hospital.

“The Surgeon General’s priority is readiness; in a way it is a concurrent mission to become a high reliability organization while maintaining a Medically Ready Force. Having safe practices will help Soldiers get the care they need,” said Hanson.

According to the Joint Commission’s website the Joint Commission Center for Transforming Healthcare aims to solve health care’s most critical safety and quality problems. JCCTH teaches organizations how to use a systematic approach to analyze specific breakdowns in care and discover their underlying causes to develop targeted solutions that solve these complex problems. A team of three JCCTH staff members, accompanied by Dr. Felicia Pehrson, from the Quality and Safety Directorate at the Office of the Surgeon General spent two days working hand-in-hand with Weed Army Community Hospital to improve current operating systems and processes of care.

The team also completed the ORO 2.0 which is a self-assessment tool used by JCCTH to identify where WACH stands in its journey towards becoming a HRO. The tool focuses on assessing the organizational safety culture, robust process improvement and leadership engagement. During the assessment phase the tool combined input from 13 key leaders within the organization. A facilitator guided discussion, elicited each individual’s thoughts and then through consensus and dialogue, provided focused objectives that the organization can use to develop it into a HRO.

“Overall it is a tool to help adapt that safety culture and high reliability culture, and this is not a one-time thing. After we assess ourselves and identify the first things we want to work on we can reassess in 18 months to see if we feel we made any progress,” said Hanson.

One way the safety culture was demonstrated was by conducting one of the Command Team’s weekly Leadership Safety Walk-through along with the patient safety representative. This week the team visited the Nutrition Care Division with JCCTH and OTSG with the goal of receiving honest staff feedback on the culture of safety at WACH. Pharmacy, Environmental Services, Mother Baby Unit and Medical Surgical Unit are some of the other departments JCCTH visited to speak with staff members.

The culminating exercise with JCCTH resulted in the creation of a tentative action plan to aid in the HRO journey. The immediate goals set by the WACH team included inculcating the zero harm message in all we do, along with several efforts to improve safety reporting and process improvement.

To learn more about Weed Army Community Hospital visit www.irwin.amedd.army.mil.

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