Commercial risk will be a critical catalyst of progress – it’s complicated, but is it possible? We think so.

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How we're helping members reduce costs while improving care quality

September 28, 2017

    Around the world each year, nurse executives gather with their peers at the Global Centre for Nursing Executives' roundtable series to discuss critical nursing issues health care organisations are facing around the word.

    These roundtables provide Global Centre members the opportunity to learn top strategies and best practices to tackle some of their most pressing challenges. At roundtables members can also network with executive peers and discuss how to adapt profiled strategies to meet their organisation's needs. Watch this brief two minute video from the perspective of senior nursing leaders who attended the roundtable last year.

    At this year's roundtable, the research focuses on how to build a highly-reliable clinical enterprise. This is timely because, despite their best efforts to improve care quality, nurse leaders around the world have reported poor compliance rates with known standards of care (“known standard of care” refers to the policies, procedures, and protocols for patient care set by a health care organisation). For example:

    • 45% observed hand hygiene compliance among nurses in a Canadian hospital (based on an observational study comparing hand hygiene compliance among physicians and nurses as documented by hospital auditors [85.8% compliance for nurses] with that observed by secret monitors, [45.1% compliance for nurses]).
    • 52% rate of adherence to patient identification checks prior to intravenous medication administration in Australia
    • 27% percentage of invasive procedures (urinary catheterisation, wound examination or closure, injections or intravascular cannulation, lumbar puncture and pleural aspiration) performed in UK Emergency Departments using aseptic technique

    In addition to the impact on safety, care quality, and patient experience, nurse leaders know that hospital-acquired conditions and preventable adverse events are associated with sizeable costs. The financial cost also prevents organisations from investing in other crucial areas. For instance, the amount the NHS in England spends annually on treatment of avoidable errors would cover the annual salaries of an additional 60,000 nurses!

    Given increased scrutiny on patient outcomes and rising consumer and regulatory expectations, nurse leaders are broadening their ambition for quality to achieve high reliability, ensuring that every patient receives the known standard of care, every time, in every setting.

    While progressive nurse leaders are already deeply focused on this issue, many leaders report plateauing quality returns and feel like they are running out of strategies to employ. 

    The Global Centre explored this challenge further, and uncovered a set of unique factors in today's environment that make it more difficult for health care organisations to achieve high reliability. They are:

    1. External Pressure to Achieve Outcomes: Greater scrutiny on organisational outcomes results in frequent, top-down mandates impacting frontline practice.
    2. One Size Does Not Fit All: It's difficult to create system-wide standards that work for all units and sites of care.
    3. More to Do in Less Time: Increased care complexity and decreased LOS add to staff workload when they already feel overwhelmed.
    4. Army of Caregivers: Care teams are growing and becoming more diverse, making it more difficult to effectively coordinate care.
    5. Proliferation of Patient Data: Increased patient complexity and reporting requirements yield unwieldy patient records.

    The good news about these complicating factors is that each presents a related solvable challenge that nurse leaders can address to ensure every patient receives the known standard of care every time. At the Global Centre's 2017 Nurse Executive Roundtables, we are equipping senior nursing leaders with executive strategies and internationally-sourced best practices to address these challenges.

    Contact us at gcne@advisory.com for more information about how nursing leaders at your organisation can attend upcoming executive roundtables or to learn more about our research on the High-Reliability Clinical Enterprise.

    Frequently asked questions about high reliability organisations


    Get answers from a leading expert at The Joint Commission about what it means to be a high reliability organisation, the steps leaders are taking to create a harm-free system for patients, and more.

    Read the Q&A

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