Safety in the Radiology Department

Radiology, as with other areas of health care, does complex work in which mistakes can cause great harm. In an effort to promote patient safety and efficient health care delivery, radiology departments and hospitals are implementing the values of high-reliability organizations (HRO). What is a high-reliability organization you may ask? Quint Studer defines a high-reliability organization as organizations with systems in place that make them exceptionally consistent in accomplishing their goals and avoiding potentially catastrophic errors. 

The initial work, research, and methodology of HROs focused on complex areas such as air traffic control towers, nuclear power plants, and naval aircraft carriers.  Unfortunately mistakes happen, and the key is to have mechanisms in place to contain and limit the damage.  In high-reliability organizations there is an atmosphere of trust and honest communication without the fear of disciplinary action.

According to Studer, there are five traits of high-reliability organizations:

1.Reluctant to accept simple explanations for problems: HROs do not accept broad, rational excuses to fix problems.  They scratch past the top layer and keep digging to find the real source of a particular problem.

2. Are sensitive to operations: In this environment, employees pay close attention to operations and what is or is not working.  There is keen attentiveness to processes which, in turn, helps assist in decision making.

3. Preoccupation with failure: In HROs there is a culture of staff being proactive rather than reactive. Constant thought is being given on ways that work processes might break down and result in inefficiencies and major failures, including medical errors. Complacency is replaced with hard-hitting troubleshooting and the need for constant improvement.

4.HROs defer to expertise: Leaders are not afraid to solicit feedback and input from front-line workers who have the knowledge about processes and department operations that will assist in the development of a HRO. In this culture, there is no hierarchy or sense of seniority. The objective is to act in the best interest of the patient and gather information from the most qualified individual, regardless of their title

5.HROs are resilient: Despite the fact the organization may experience failures; leaders stay the course in what they are doing.  These organizations are continually looking for ways to improve and respond to unexpected events. It is their resilience and quick problem solving that prevent catastrophes from occurring.

Our facility is working towards becoming a high-reliability organization and these five principles can be applied to your departments as you begin your quest to be a HRO.