For the last two years, Hartford HealthCare, a six-hospital system based Connecticut, has sustained a 70 percent reduction in serious safety events – an outcome that has been five years in the making.
The journey to becoming a highly reliable healthcare system means eliminating errors, system failures and, ultimately, harm.1 In the case of Hartford HealthCare, that journey began with a singular focus aimed to advance safety across its system by adopting a model of high reliability. The goal was to decrease the incidence of patient harm not just within hospitals, but across the entire health system.
“When events that have happened make you say, ‘How could this have happened in one of my hospitals?’ and make you feel that they never should have happened, it drives the work,” said Dr. Rocco Orlando, III, Chief Medical Officer at Hartford HealthCare.
After achieving buy-in from system leadership, Hartford HealthCare began implementing a series of new processes and cultural changes that emphasized the new goal of advancing safety, which included:
- Providing high reliability organization (HRO) training to both new and current employees.
- Coaching leaders to use high reliability principles within day-to-day operations.
- Emphasizing high reliability during meetings.
- Tracking data for harm and serious safety events.
- Implementing HRO training for non-acute entities within the health system, including the medical group, behavioral health network and skilled nursing facilities.
Hartford HealthCare, a longtime member of Premier®, began as a QUEST® member valuing collaboration and shared best practices. As the system embarked on its high reliability journey, it more heavily looked to Premier’s QualityAdvisor™ technology to gain visibility into data insights and benchmark capabilities.
“Our relationship with Premier gave us the ability to measure ourselves to external hospitals and health systems,” said Stephanie Calcasola, RN-BC, MSN, CPHQ, Vice President of Quality and Safety at Hartford HealthCare. “It’s allowed us to be transparent about where we are in the process and leverage the opportunity to learn from others and accelerate our performance.”
Throughout the five-year engagement, Hartford HealthCare used Premier’s data to set annual target outcome goals for the health system as well as specific goals for individual hospitals and units. In addition, Premier’s QualityAdvisor data enabled leaders to publish monthly performance reports in quality areas and post progress updates on set goals, which resulted in creating transparent standards across the health system.
“Performance isn't linear, and we work in a system that's complex,” said Calcasola. “We recognize that to do the work and make improvements, it can take more than a year. So, goal setting is important in terms of what can we achieve. Meeting those goals also takes engaged leaders, committed staff, a culture of high reliability, and the right tools and methods.”
Premier’s QualityAdvisor data also allowed leaders to pinpoint quality variations and target specific efforts to reduce harm across the system. As a result of its multi-pronged approach to reduce harm, Hartford HealthCare has sustained a 70 percent reduction in serious safety events for nearly two years with plans to continue pushing toward transformation and high reliability.
“It's all one thing,” Dr. Orlando said. “We're now building capability to add to the foundation that we've already built.”
1 “E-book: Journey to High Reliability,” Premier, Inc., October 2017