The Joint Commission CEO Mark Chassin: Reaching zero harm requires cultural change

Current quality improvement initiatives aren't enough to help organizations achieve zero harm, according to The Joint Commission CEO Mark Chassin, MD.

Speaking at the 2018 American College of Healthcare Executives Congress on Healthcare Leadership March 26 in Chicago, he outlined how fundamental changes can help providers achieve zero harm, HealthExec reports. Here are seven takeaways. 

1. Assuming a high-reliability, zero-harm philosophy "requires a very careful attention to process, to culture, to leadership focus," Dr. Chassin said. "It's not a project. It's not something you, as leaders, delegate to somebody else. It becomes the way you work."

2. Healthcare should adopt the general principles from high-reliability organizations in other industries, such as air travel, nuclear power and amusement parks.

Approaches in these fields include "having leaders taking full responsibility for major changes like zero harm and valuing when errors are identified," according to Health Exec.

3. Organizations should treat quality improvement as a cultural change rather than a project. The Joint Commission provides resources to ease this transition, including:

  • Self-assessment tools
  • Robust Process Improvement and change management training
  • Working with state hospital associations

4. Current initiatives that accept "30 percent good outcomes, 70 percent failure" or neglect to maintain outcomes prevent organizations from achieving zero harm.

5. High-reliability initiatives are effective because they set goals based on an organization's specific problems, Dr. Chassin said.

6. Safety should no longer be just a priority — it should be "a core value which just can't be compromised," according to Gary Yates, MD, a strategic consulting partner at Press Ganey.

7. Houston-based Memorial Hermann Health System is one organization striving to achieve zero harm. The organization has spent $18 million on "safety culture training" alone and puts safety reports at the top of board meeting agendas.

Memorial Hermann's hand hygiene compliance rate shot up to 96 percent from an average of 58 percent after it employed The Joint Commission's "targeted solutions tools." As a result, Memorial Hermann achieved zero instances of harm on certain measures, such as ventilator-associated pneumonia and surgical site infections.

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