The journey to high reliability continues

December 11, 2018  //  FOUND IN: Strategy & Leadership

In late November, partner consultant Healthcare Performance Improvement (HPI) returned to campus to continue the process of helping Michigan Medicine become a highly reliable organization.

After having conducted a thorough analysis of the organization’s safety data and interviewing more than 300 employees in focus groups, HPI was onsite Nov. 29-30 to present its findings.

In general, HPI indicated that Michigan Medicine employees are very articulate and informed about areas of opportunity for the institution, but need help with the next steps to make sustainable improvements.

In the journey to zero harm, it has been demonstrated that “prevention, detection and correction” are the keys to significant reductions in medical errors and safety events.

Michigan Medicine’s engagement with HPI focuses on prevention and establishing a safety culture where all employees consider safety one of the organization’s highest priorities.

Based on their research, HPI shared five key areas of opportunity that will influence the organization’s safety culture:

  • Conflicting messages: Employees experience competing priorities and reflect a physician/staff-centric culture rather than a patient-centric culture.
  • Change management: The organization tends to be resistant to change and has opportunity to better manage change initiatives.
  • Structure and operational leadership: There is some confusion about the chain of command and decision-making authority, which can lead to delays in patient care.
  • Authority gradient: Power imbalances between faculty and staff may cause fear of escalating issues and speaking up.
  • Process improvement: A culture of individualism reduces high reliability and can impede seamless transitions in care.

To learn more about HPI’s findings, the Office of Patient Safety will be hosting two High Reliability town halls to review the information presented by HPI. All faculty and staff and welcome to attend.

  • Feb. 5, 2019: Ford Auditorium, 10 – 11 a.m.
  • Feb. 12, 2019: NCRC Research Auditorium, 9 – 10 a.m.

Representatives from the Office of Patient Safety are also available to visit individual departments or units to discuss the findings of HPI’s research.

Over the next couple of months, HPI will be preparing for their next visit to Michigan Medicine, when they will initiate the design phase of the journey to high reliability.

In February, they will meet with the High Reliability Steering Committee and many others to begin formulating the training and education plan for leaders, trainers and all employees. Once this plan has been created, training will begin with the leadership group.

For more information or to request a visit, please contact Robin Rachel at