Leveraging PI CME to Design a Longitudinal Activity to Improve Patient and Team Safety utilizing the Highly Reliable Organization Framework

This innovative and interactive session aims to teach learners how to design and operationalize a Performance Improvement (PI) CME activity using the Highly Reliable Organization (HRO) framework as an example. Based on a real activity design, participants will have an opportunity to hear about facilitators and barriers to the design, tips and tricks for collaboration and obtaining buy-in from stakeholders, how to include multiple evaluation methods throughout the activity, along with hearing the preliminary results for The Permanente Medical Group’s (TPMG) implementation of the HRO PI CME activity. Participants will have an opportunity to apply the HRO framework in an interactive activity and will be able to take home a blueprint and other resources for use in their own programs.

The HRO organizations “operate under very trying conditions all the time and yet manage to have fewer than their fair share of accidents.” (Managing the Unexpected (Weick & Sutcliffe). Organizations such as naval aviation, commercial aviation, and nuclear power are all highly reliable and healthcare organizations across the country are taking the lessons learned from these industries and applying them to the healthcare environment to increase the level of safety for patients.

Highly Reliable Organizations have a number of key characteristics that make them “reliable” and allows them to sustain high performance during challenging times. They have five traits or attributes that allow them to stay out of trouble and manage unexpected events when they cannot prevent them.  The principles include: a preoccupation with failure; reluctance to simplify; sensitivity to operations; deference to expertise; and commitment to resilience. The TPMG Ambulatory HRO Program took those five elements and created a PI CME activity with the goal of leveraging current structures and processes to reinvigorate healthcare teams with consistency in providing a safe, effective, timely, equitable, patient-centered, and efficient care by utilizing high reliability science.

The expected outcomes for the activity included increased psychological safety in the office; improvement in one performance goal as set by the medical center; incorporation of the HRO principles into daily huddles; incorporation of the HRO principles into leader rounding; incorporation of quick debriefs at the end of the day; and incorporation of a formal peer check-in process to build staff resilience. With those outcomes in mind, the PI CME activity was built to help teams use the HRO principles and incorporate structured Huddles, Peer Check-ins, and end of the day Debriefs into their day-to-day activities.

When combined with the PI CME structure, the TPMG Ambulatory HRO Program was elevated by adding legitimacy to the activity by being CME certified, creating a space for interacting with participants in their longitudinal PI efforts, along with providing credit to participants for their work, and continuing our CME Program’s excellence by qualifying for several of the commendation criteria. These benefits were appreciated by our organization’s leadership along with the activity participants, which facilitated both buy-in and engagement in the activity.

Pearls from our learnings, along with hands on activities for applying the HRO framework, interactive discussions, and Q&A will benefit learners who are itching to try something new and innovative in their CME programs. Participants will gain a better understanding of the PI CME framework and will be able to apply the framework to quality improvement initiatives, along with implementing the HRO program tailored to their own organization. They’ll also take away a blueprint of how to create a PI CME HRO activity along with other tools and resources.

Unlock Your Potential : This session will inspire learners to explore the use of PI CME in creative ways within their organizations to improve patient care.