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"Preoccupation with Failure" is a fundamental principle of High Reliability Organizations (HROs), particularly crucial in high-risk environments like healthcare. This principle encourages organizations to constantly assess their processes, identify potential risks, and proactively address vulnerabilities before they escalate into serious incidents.

In healthcare, where even minor mistakes can have life-threatening consequences, preoccupation with failure is essential. By continuously monitoring for potential hazards and actively seeking areas for improvement, healthcare organizations can establish a culture of safety that prioritizes patient well-being above all else. This culture is built on the principles of leadership commitment to zero harm, an organizational safety culture where all staff can speak up, and an empowered workforce that employs robust process improvement tools.

Frontline staff, including housekeepers and nurses, play a vital role in this culture of safety. Every staff member is responsible for remaining vigilant and speaking up when they identify potential risks. For instance, a housekeeper noticing a wet floor or a nurse recognizing a medication error can prevent errors before they occur. By fostering a culture where all team members feel empowered to address issues and contribute to solutions, healthcare organizations can enhance patient safety.

A practical example illustrates the impact of this principle: A housekeeper identified a leaking water cooler that could have caused a fall, potentially resulting in major injuries to patients, employees, or visitors. By acting proactively to address the water spill and its source, the housekeeper averted an untoward incident. This action not only prevented a serious injury but also prompted the hospital to implement new protocols to prevent similar incidents in the future. This example highlights the significant impact individual vigilance can have on patient safety.

The HRO principle of "Preoccupation with Failure" is essential for creating a culture of safety in healthcare. By encouraging staff at all levels to remain vigilant, identify potential risks, and proactively address vulnerabilities, organizations can minimize errors and enhance patient well-being. This commitment to learning from failures and continuously improving processes is key to preventing harm and creating a safer healthcare environment for all.

High Reliability Organizations (HROs) are the gold standard in industries where the stakes are high, and risks are ever-present. In the healthcare sector, HROs set the bar high by prioritizing patient safety and staff support. Picture a hospital where every team member is empowered to speak up and collaborate seamlessly, resulting in enhanced performance and exceptional outcomes.

In healthcare where split-second decisions can make all the difference, HRO principles offer a roadmap to success. By fostering a culture of continuous improvement and communication, healthcare organizations can navigate complexity with ease and ensure optimal care for their patients. It's not just about meeting standards – it's about cultivating a mindset of excellence that elevates the entire organization.

So, embrace the principles of HRO and watch your healthcare organization soar to new heights of success and compassion. With a commitment to innovation and a focus on patient well-being, and employee engagement you can transform your organization into a true leader in healthcare. Don't just meet expectations – exceed them, with HRO principles guiding the way.

1. If possible, allow yourself time to gain experience in quality. Taking the exam without any background in quality may be challenging. Hands-on experience in Quality can put you ahead.
2. Prepare using different resources: books, practice exams, and possibly the CHPQ review course.
3. Have a practice plan. Do not go ahead and memorize books or practice tests. Logical and practical thinking is also important.
4. Create your own flash cards. Certain styles of questions tend to be included in many of the practice exams and ultimately in the CPHQ exam.
5. As you’re reading exam books, mark pages and highlight crucial information to come back to.
6. The exam will cover four topics which are Organizational Leadership, Patient Safety, Performance and Process Improvement, and Health Data Analytics. Some of these sections such as Performance and Process Improvement will include more questions than others. You should master these sections to maximize your chances.
7. Beware of websites that offer free practice tests. Some of them provide the wrong answers to questions that may conflict with the book and mislead you.
8. Identify areas you are weak in and allot more time for them to improve your performance.
9. Give yourself a deadline by which you will want to take the test. You shouldn’t study for longer than three months or may risk forgetting what you’ve learned.
10. To motivate yourself, register for the exam before you start preparing. You’ll have three months to sit for it. The hefty cost will certainly be a big push for you to succeed.
11. Review the US CPHQ Candidate Handbook from NAHQ to learn about the exam structure, types of questions and more.
12. Complete the pretest questions at the beginning of the exam. They are not part of your final score but can help get you warmed up for the test.
13. Read the questions carefully to not miss any key information. Pay attention words such as EXCEPT, NOT, LEAST, ALWAYS, NEVER…
14. If it takes you longer than one minute to answer a question, mark it, skip it and move to the next.
15. If you are unsure of the right answer, eliminate obvious wrong answers first then choose the best answer considering logic and different alternatives.
16. Use the extra time at the end to revisit questions you skipped or were not confident in.

Have additional tips and tricks to share? Let us know in the comments below!

My journey into healthcare quality happened by accident. I had been working at an academic medical center in an operations training role when I was asked to take over the management of 6 departments and 50+ employees. As I set out to learn more about the departments and staff, it was immediately apparent that they didn’t have a clear pulse on how their departments were performing against organizational expectations, or whether or not they were meeting their individual goals.   It was clear that performance metrics needed to be introduced, but I knew it wouldn’t be easy, as many of the staff had been in the same role for 15-20 years without really knowing how well they were performing.  We started small, with industry best practice metrics for the type of job they were performing. Dashboards were created, and individual performance assessments developed.  We met weekly in each department to review metrics, and scheduled 1:1 meetings monthly to review individual performance. Though there were eye rolls, resistance, and lots of doubt in the beginning, after a while it became their normal. When performance started improving, I would find ways to celebrate those small wins with coffee/donuts or cake. Soon enough, an amazing thing happened…the staff started telling me when we were exceeding goals instead of me telling them, and they brought ideas to the table that would make them further succeed. It was a beautiful thing really, and made me realize that measuring performance against goals and talking about how to improve was fascinating and exciting.  This led me down the path of healthcare quality.

Soon after this epiphany, I left the organization that I was at for a Quality Management role at a managed behavioral health organization.  There, I developed internal strategy to measure and execute adverse incident and member grievance investigations more efficiently in accordance with regulations; I led interdisciplinary teams to work on projects that would improve our clients HEDIS measure performance, and I helped develop policies, work plans, and data measurement to support NCQA accreditation.  Subsequently, I joined a health system as the Director of Physician Network Quality, where I worked with leaders, physicians and staff improvement of preventative care metrics such as colorectal and breast cancer screening, as well as diabetes, depression, and blood pressure screening. I helped them understand patient experience metrics, and suggested ways to improve. I worked with CMS and other payers to report performance and meet regulatory requirements.  In both of these roles, it was clear that looking at and understanding data was the key to improving. It was at this time that I also joined NEAHQ with the goal of helping to create educational programs for those in healthcare quality careers or interested in pursuing them.

I recently took a role in managed care, and I’m working with Accountable Care Organizations (ACOs) on strategies to improve clinical quality metrics and coding.  I continue to be passionate about presenting data and educating my clients on ways to improve.  I love seeing pride on people’s faces when they exceed goals. It’s so gratifying, especially knowing that I’m also indirectly helping to improve the lives of the patients we serve by ensuring proper screening and management of disease.

Communicate with Empathy

Patients are often dealing with both physical and emotional aspects of their illness or injury, in addition to other socioeconomic matters – financial struggles, employment status, family dynamics.  They want to feel as though their healthcare providers and medical office staff understand what they are dealing with, and care about their feelings and needs. This means actively listening, being aware of the whole story, and acknowledging their concerns. It also involves making eye contact, sitting at their level, and incorporating caring statements such as “I can imagine this is difficult, but my staff and I are here to help you” or “This situation must be frustrating, let’s figure out how I can help.”

Manage Expectations

Patients want to know what to expect – how long will they be in your office for their follow-up visit? When will they receive test results? What type of side effects might their new medication present, and for how long? How many minutes behind is their healthcare provider running? When information is provided proactively, and they are kept informed about issues or delays, they are more likely to be content with their experience.

Be Prompt

Are patients told to show up 15 minutes prior to their appointment, only to wait 20 or more minutes to see their healthcare provider?  Are they roomed upon arrival, but waiting in the exam room wondering if they’ve been forgotten about? Recognize that patients have a sense of urgency and demonstrate that you value their time. Unnecessary wait times contribute to negative patient experiences.

Take Accountability

When mistakes happen, as they inevitably do, acknowledge and apologize with sincerity, and take accountability to mitigate the issue and prevent it from happening in the future. Follow through on commitments that are made. Provide additional service amenities for those who have been inconvenienced or may need special assistance. Limit distraction, and verify pertinent information to ensure mutual understanding. Provide effective handoffs to all care team members.   Ask “Did I answer all of your questions today?” or “Is there anything else I can help you with?”

Show Gratitude

Patients have options, but they choose to receive services at your practice. Thank them and show appreciation.  A little gratitude can go a long way, and it’s free!

Alyson Mitchell

System Director, Physician Network Quality at Covenant Health

Do you want to network with other quality professionals but don't have the time to regularly attend in-person meetings?

Have you ever wanted to ask a question of your peers or exchange best practices?
 

You can do all of this and more with NEAHQ's Member Forums! Member Forums are your online, interactive presence with other New England healthcare quality professionals: 

• Connect with professionals in your area or specialty
• Pose questions
• Exchange or inquire about best practices 
• Seek guidance and give feedback
   

There are currently three NEAHQ Member Forms focused on the following topics and subject-areas: 

• Accreditation & Compliance
• Data Analytics 
• Quality Leadership & Networking
   

Go for it! Ask a question, share a best practice, or reach out and network with your peers. 
 

Find the Member Forums under the “Groups” tab or at this link: www.neahq.org/groups/member-forum

NEAHQ’s new website has an expanded and improved members-only section, complete with access to a membership directory.  Now you can easily discover new connections and stay in touch with other members. 

Navigate to the membership directory by logging in* and selecting "Directory" under the "Membership" tag of the navigation bar.


 

Once on the directory page, use the search bar to search for companies and other members.  You can also filter by the first letter of the person's last name.

Once you find the member you're looking for, you can either click "Profile" to view their profile, or "Contact" to send a message.

*For existing members, click on “LOGIN” in the top right-hand corner of the site and simply type in the email you used to register under and click on “Forgot Password” to reset your password and create your web account. For those who wish to become members, click on “JOIN NOW” in the top right-hand corner and follow the registration prompts to join and create your online account.

NEAHQ’s new website has an expanded and improved members-only section, complete with access to a membership directory. Once you create your NEAHQ account on the website*, you can set up a personal profile, like something you would find on LinkedIn but with a healthcare quality focus. The profile you create will appear under the member directory, where other members can view your profile and message you. In addition, as a NEAHQ member you will have access to the following tools and resources:

• Healthcare Quality Job Board: Browse healthcare quality job opportunities to further your career or post an opportunity at your organization for other members to see. 
• Member Forums: Use these virtual platforms to exchange information with other NEAHQ members about healthcare quality trends and issues. Member forums allow you to ask a question of your professional peers or share a best practice from your work to move healthcare quality forward.  
• Archived Events: Did you miss an in-person event or webinar? As a NEAHQ member, you can access archived events so you will never miss an opportunity to stay up to date with the healthcare quality knowledge.

All of these improvements aim to bring the New England quality community closer together by providing a platform for shared learning and professional connection. Create your profile today and start connecting with other NEAHQ members!

*For existing members, click on “LOGIN” in the top right-hand corner of the site and simply type in the email you used to register under and click on “Forgot Password” to reset your password and create your web account. For those who wish to become members, click on “JOIN NOW” in the top right-hand corner and follow the registration prompts to join and create your online account.