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Advancement toward High Reliability in Healthcare Awards Program

Advancement Toward High Reliability in Healthcare logo

The Department of Defense is on a journey to transform the Military Health System into a high reliability organization, or HRO, to ensure safe, reliable care for all patients and their families. Today, across the MHS, there are a number of actions already in motion to help the MHS advance toward high reliability and ensure that we partner with patients every step of the way to provide the care they deserve.

The Advancement toward High Reliability in Healthcare Awards Program aims to recognize those who have shown initiative and commitment to the development of systems and processes that will help advance the MHS towards its goal of becoming a safer, higher quality system that promotes a culture which encourages learning, sharing and, continuous improvement. Awards will be presented in the following disciplines: Leadership Commitment, Culture of Safety, Continuous Process Improvement, and Patient-Centeredness. These awards are also an opportunity to submit a project that aligns with a Clinical Community, driving improvement across the organization.

The award domains were adjusted in 2020 to better reflect High Reliability Organization (HRO) principles across the Enterprise. This adjustment aims to align the work being done at the MTFs to MHS-wide HRO efforts. The new categories, shown below, encompass the same types of initiatives in years past and will be judged using similar criteria.

The award submissions will be evaluated based on the use of the seven MHS HRO Guiding Principles: 1) Preoccupation with Failure, 2) Sensitivity to Operations, 3) Deference to Expertise, 4) Respect for People, 5) Commitment to Resilience, 6) Constancy of Purpose, and 7) Reluctance to Simplify.

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Award Disciplines

Leadership Commitment Award

HRO Leadership Commitment is demonstrated when leaders champion HRO through their goals, focus, guidance, involvement, and resources. Being hands-on with quality goals and strategy and attentive to the safety of patients and staff also reflects that commitment. Leadership engagement is critical to promote a psychologically safe environment in which staff feel empowered to speak-up, share ideas, questions, or concerns without fear of reprisal or humiliation. Without psychological safety, staff may be hesitant or unwilling to admit gaps in knowledge or mistakes, and they may be uncomfortable questioning the actions of others on the team that can compromise an environment of zero harm.

Leadership Commitment initiatives for award consideration must fall into or address one of the below areas; initiatives may be in either primary or specialty care:

  • Improving Leadership Engagement Strategies and Practices.
  • Leaders Enable HRO Principles to be Demonstrated in Practice and Organizational Culture.
  • Organization Highlights Quality as a High Priority.
  • Leaders Comit to IT Solutions Integral to Sustain and Improve Quality.
  • Physician-led Clinical Quality Improvements.

Culture of Safety Award

Promoting a Culture of Safety means to implement a system-wide culture that collectively advances towards zero harm.

Culture of Safety initiatives for award consideration must fall into or address one of the below areas; initiatives may be in either primary or specialty care:

  • Reduce Harm.
  • Enhancing Culture of Safety.
  • Implementing Initiatives to Address DoD Patient Safety Culture Survey Findings.
  • Improving Staff Burnout.
  • Implementing Employee Recognition Programs that Enhance Reliability.
  • Promoting Teamwork.
  • Establishing Health Metrics to Improve Safety.
  • Reducing Healthcare Acquired Conditions/Infections.

Continuous Process Improvement Award

Continuous Process Improvement (CPI) is at the core of Ready Reliable Care. CPI is focused on reducing unwarranted variation across the system, eliminating waste and lowering costs. The MHS Benefits best from CPI when an integrated system is organized for every member to be a problem-solver capable of leveraging improvement science.

Continuous Process Improvement initiatives for award consideration must fall into or address one of the below areas; initiatives may be in either primary or specialty care:

  • Implementing Leading Clinical Improvements.
  • Implementing Improvements Across a Continuum of Care.
  • Preventing Readmissions.
  • Developing Strategic Clinical Partnerships.
  • Reducing Unnecessary Utilization of Care.

Patient-Centeredness Award

Patient-centeredness includes patients in decision-making about their care, embraces patient engagement, advocacy, and education, and promotes healthcare from the patient perspective.

Patient-centeredness initiatives for award consideration must fall into or address one of the below areas; initiatives may be in either primary or specialty care:

  • Innovations in Patient Centered Access and Care Delivery.
  • Improving Patient/Family Engagement or Patient Care Experience.
  • Innovations Partnering with Patients/Families in Care Decisions.
  • Improving Utilization of Communication Methods to Patients/Families, such as Virtual Communication Tools.
  • Enhancing Patient and Staff Safety through Education.

All facilities within the MHS including in-patient, ambulatory health clinics, dental clinics, and operational units are eligible to submit an application focusing on one of the above disciplines. Managed care support contractors, overseas contractor, and designated providers are also encouraged to submit.

Award selections are made through an internal board process using numerous reviewers with expertise in quality improvement and patient safety, education, data analysis, information management, case/care management, patient experience, patient-centered medical homes, information technology, change management, innovation, clinical communities, and health care.

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