VA selects 18 medical facilities to start ‘high reliability’ journey: Initiative creates safe industry-wide environments with robust continuous process improvements

WASHINGTON — Today the U.S. Department of Veterans Affairs (VA) announced the selection of 18 medical centers that will lead the way in the department’s efforts to transform the nation’s largest integrated health care system into a high reliability organization (HRO).

Pioneered in highly complex environments, such as aviation and nuclear energy, HROs put procedures and protocols in place that maximize safety and minimize harm, which in the medical industry assures every patient receives excellent care, every time.

“VA has been a leader in patient safety for years,” said VA Secretary Robert Wilkie. “Adopting high reliability principles more formally represents the next step for delivering the best health care to Veterans.

“These principles align with our greater vision of transforming business operations and delivering exceptional customer service to Veterans,” Wilkie said. “Our culture is changing and pursuing HRO principles nationwide is our pledge to empower staff and keep Veterans the safest they can be on our watch.”

Research shows high reliability organizations experience fewer accidents despite being high-risk environments where small errors can produce catastrophic results. A February Leadership Summit kicked off the HRO journey and introduced high reliability concepts and practices to the 18 sites. Lessons learned from these 18 sites will guide a more impactful rollout across every Veterans Health Administration (VHA) medical facility in 2020.

The 18 sites selected are: Manchester VA Medical Center (VAMC) (N.H.); Albany Samuel S. Stratton VAMC (N.Y.); Erie VAMC (Pa.); Beckley VAMC (W.Va.); Durham VAMC (N.C.); Ralph H. Johnson VAMC (Charleston, S.C.); James A. Haley Veterans Hospital (Tampa, Fla.); James H. Quillen VA Healthcare System (HCS) (Johnson City, Tenn.); Louis Stokes Cleveland VAMC (Ohio); William S. Middleton VA Hospital (Madison, Wis.); Kansas City VAMC (Mo.); G.V. Sonny Montgomery VAMC (Jackson, Miss.); Audie L. Murphy VA Hospital (San Antonio, Texas); Oklahoma City VA HCS (Okla.); Boise VAMC (Idaho); VA Sierra Nevada HCS (Reno, Nev.); VA San Diego HCS (Calif.); and St. Cloud VA HCS (Minn.).

The VHA journey to become an HRO is consistent with national safety goals set forth by the Joint Commission, an independent, nonprofit organization that accredits and certifies approximately 21,000 health care organizations and programs in the U.S.

In addition to a safer environment focused on reducing errors and preventing patient harm, HRO principles and values call for deference to expertise; oftentimes, the patient’s family caregiver is that expert. HRO will empower Veterans and their family caregivers, along with employees who work hands-on with Veterans, to make decisions and impact improvements that aim for excellent care for every patient, every time.