Health care may be able to transform itself from an industry in which islands of excellence are surrounded by a sea of serious and preventable adverse events into one that rarely fails by learning from other industries, according to "The Ongoing Quality Improvement Journey: Next Stop, High Reliability," published in Health Affairs. The article, written by Mark R. Chassin, MD, FACP, MPP, MPH, president, and Jerod M. Loeb, PhD, executive vice president, Health Care Quality Evaluation, both of The Joint Commission, concludes that the U.S. health care industry has the ability to achieve and sustain consistent excellence in safety and quality. It can do so by focusing on the three components that are necessary to achieve high reliability in health care--leadership, safety culture, and Robust Process Improvement.

Preventable harm affects millions of Americans each year and may be on the rise in hospitals because patients are sicker and care is increasingly complex. Achieving and maintaining consistently high levels of safety and quality over time and across all health care services and settings must be the goal.   

Specifically, the Health Affairs article contends that:

• Health care leadership must make it clear that high reliability is the priority, right now and as long as it takes to achieve desired results
• Health care organizations must create a culture of safety that emphasizes trust, reporting of unsafe conditions, and improvement
• Organizations must use proven quality improvement methods--Lean, Six Sigma, and change management (known together as Robust Process Improvement)--to systematically improve processes and avoid common, crucial failures.

"Our aim for health care must be higher. Although we know of no health care organization that has been able to achieve a consistent state of high reliability, we must commit ourselves to reaching this goal," says Dr. Chassin. "We must strive for high reliability. It is our obligation to patients because it offers the best hope for health care to achieve and sustain the elusive goal of consistent excellence in safety and quality. It is paramount to achieving our vision that all people always receive the safest and highest quality health care."