Assignment: High Reliability in Health Care – LongTerm Care

Assignment: High Reliability in Health Care – LongTerm Care
  • Description

There are three imperative steps that need to be taken. The first is a strong commitment by leadership to this very high level of safety and quality. The leadership must set the goal and example for everyone in order to achieve high reliability. The second is to embed all of the principles and practice of a culture of safety throughout the organization which emphasizes trust, reporting of unsafe conditions, and highly effective improvement over time. The third step is to utilize powerful Robust Process Improvement tools like Six Sigma, Lean, and change management to create near perfect processes, similar to the tools that we see in industries like commercial aviation today, and sustain very high levels of safety over long periods of time.

—Dr. Mark R. Chassin

These three steps: commitment by leadership, development of a culture of safety, and the use of process improvement tools, are the core recommendations made by Dr. Chassin, the president of The Joint Commission and the president of the Joint Commission Center for Transforming Healthcare. A first step in identifying whether these recommendations are being met is to compare elements of an organization to criteria which have been identified as essential to high-reliability organizations.

To prepare for this Assignment:

Consider the three steps described by Dr. Chassin and the seven major criteria of the Baldridge Performance Excellence Program, and reflect on how these recommendations can apply to health care organizations, specifically to long-term care facilities.

The Assignment:

In this Assignment you will identify major elements of high-reliability organizations providing long-term care. According to the Baldrige Performance Excellence Program (MBNQA), the criteria are as follows:

  • Leadership
  • Strategic planning
  • Customer and market focus
  • Measurement, analysis, and knowledge management
  • Human resource focus
  • Process management
  • Business/organizational performance results

Using the Highly Reliable Organization Matrix located in this week’s Learning Resources, complete the matrix by typing in the elements which meet the criteria in rows and columns. Describe each element briefly, give an example as to how this can be met in a long-term care facility, and explain the expected impact on patient care.

Based on the results of the Highly Reliable Organization Matrix, write a 1- to 2-page executive summary to the board of directors of the long-term care organization, describing elements which meet the criteria from the matrix and how any missing elements of the criteria for excellence can be met.

Resources that we can use to complete assignment.

Review the following resources to prepare for this week’s Assignment:

Hayes, C. W., Batalden, P. B., & Goldmann, D. (2015). A ‘work smarter, not harder’ approach to improving healthcare quality. BMJ Quality & Safety, 24(2), 100–102. Retrieved from

A ‘work smarter, not harder’ approach to improving healthcare quality by Hayes, C. W., Batalden, P. B., & Goldmann, D. in BMJ quality & safety, 24(2). Copyright 2015 by BMJ Publishing Group Limited. Reprinted by permission of BMJ Publishing Group Limited via the Copyright Clearance Center.

Hearld, L. R., Alexander, J. A., Shi, Y., & Casalino, L. P. (2014). Pay-for-performance and public reporting program participation and administrative challenges among small-and medium-sized physician practices. Medical Care Research and Review, 71(3), 299–312.

Note: Retrieved from the Walden Library databases.

McKethan, A., & Jha, A. K. (2014). Designing smarter pay-for-performance programs. JAMA, 312(24), 2617–2618.

Note: Retrieved from the Walden Library databases.

Ryan, A. M., & Mushlin, A. I. (2014). The Affordable Care Act’s payment reforms and the future of hospitals. Annals of Internal Medicine, 160(10), 729–730.

Note: Retrieved from the Walden Library databases.

National Institute of Standards and Technology (NIST). (2015c). Baldrige performance excellence program. Retrieved from

Schoenberg, M., Heider, F., Rosenthal, J., Schwartz, C., & Kaye, N. (2015). State experiences designing and implementing Medicaid delivery system reform incentive payment (DSRIP) pools. Retrieved from

Document: Highly Reliable Organization Matrix (Excel spreadsheet)

Required Media

HenryFordTV. (2011, November 23). Henry Ford Health System CEO discusses Baldrige Award [Video file]. Retrieved from

National Institute of Standards and Technology (NIST). (2013, May 24). President Obama congratulates 2012 Baldrige Award recipients [Video file]. Retrieved from

St. David’s Healthcare. (2015, April 17). Baldrige awards ceremony [Video file]. Retrieved from


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