Making quality stick: Optimal Resources for Surgical Quality and Safety: Creating a culture of high reliability

Editor’s note: In July 2017, the American College of Surgeons (ACS) released Optimal Resources for Surgical Quality and Safety—a new manual that is intended to serve as a trusted resource for surgical leaders seeking to improve patient care in their institutions and make quality stick. Each month, the Bulletin will highlight some of the salient points made throughout the “red book.”

Optimal Resources for Surgical Quality and SafetyTraditionally, the health care culture has revolved around a long-established hierarchy; divisions, departments, and disciplines that operate in silos; normalized deviance for the sake of expediency; and assignment of “blame and shame” when mistakes occur. A growing body of evidence has shown that this culture impedes the ability of health care institutions to create a learning environment and to ensure the delivery of coordinated, patient-centered care. As a result, many health care organizations are working to establish a culture that incorporates the principles applied in high reliability organizations (HROs), such as an emphasis on systems-based care, transparency, teamwork, nonpunitive analysis of errors, and best practices.

Optimal Resources for Surgical Quality and Safety describes the specific tools that surgeon leaders can use to cultivate a culture of patient safety and high reliability, including patient safety reports and open discussion of errors, root-cause analysis, and the examination and interpretation of registry data. Clinical practice guidelines and bundling of essential safety elements—policies and procedures, order sets, checklists, and so on—are highlighted. The red book emphasizes that ultimately it is the surgeon champion who is responsible for ensuring that these tools are successfully implemented and for achieving across-the-board compliance with safe practices that lead to reliable outcomes.

Be sure to read next month’s overview of the red book, which will focus on disease management and multidisciplinary care in the surgical specialties and external regulation of quality and patient safety. Optimal Resources for Surgical Quality and Safety is available for $44.95 per copy for orders of nine copies or fewer and $39.95 for orders of 10 or more copies at facs.org/redbook.

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