What is a Cohort organization? HCRO Cohorts are those healthcare organizations that have been recognized by HQI for having committed to the following:
- Organization-wide completion of HCRO Foundations learning modules
- A minimum six month onsite collaborative engagement (per facility) with an HCRO Strategic Partner
- A commitment to implement the HCRO Reliability Management System (RMS™)
Healthcare organizations that are on the HCRO Cohort journey can expect to see measurable improvements in targeted performance areas when Cohort work begins.
Completion of the above requirements leads to recognition as an HCRO Partner, with the ongoing commitment to sustain an active HCRO RMS™ to become a partner in the HCRO Community of Practice. Reliability is the pathway to sustainable, enterprise-wide improvements, greater safety, and better outcomes.
In light of our understanding about the sequence of healthcare reliability organizing and the requirement of sustainable and continuous innovation to reliably meet new challenges and the changing world of healthcare, we can define the steps necessary to achieve sustainability, resilience, and innovation for reliable healthcare.
Sign Commitment and Compact
The starting point on the journey to HCRO is establishing leadership commitment, starting with the C-Suite. This is no small task, and in order to be successful, the leaders must understand what HCRO is, and just as importantly, what it is not. It is critical that HCRO is understood to be more than just another patient safety or quality improvement program. HCRO is a unifying framework for seeing, predicting, and managing risk across all departments and work groups. It supports multiple values, including, but not limited to safety (patients, visitors, and workforce), clinical effectiveness, privacy, compassion, and fiscal stewardship. HCRO is just as important to our environmental and support services colleagues, and our financial teams, as it is to our frontline caregivers, physicians, and providers. Included in this step is the selection of an Executive Sponsor and Champions team to guide and lead the transformation to HCRO.
Import New Knowledge
Once commitment is secured to the HCRO journey, we begin to import new knowledge and skills from the science of reliability. Our strategy is to embrace the “reverse classroom” model of learning, i.e., to meet adult learners where they are best able to access and retain the knowledge. While classroom instruction can be effective, there are limits to what we can achieve and afford in the traditional setting. Utilizing the latest advances in technology, we are able to provide short, engaging learning modules designed for optimal cognition and retention, consumable on any electronic device, from laptops, tablets, and cell phones to group settings in theatre-style venues. A chief advantage to our approach is that we can provide multiple modes of learning to achieve optimal results at a cost effective advantage in the economic pressures of our industry.
Integrate the Socio-Technical Science of Performance Improvement
Educators and learners alike will agree on a fundamental HCRO principle: Education alone will not result in behavioral change and improvement. In most cases, if we want to change behavior in support of managing risk, we must first understand what motivates us as human beings. An effective way to do this is to align strategies for improvement with workforce self-interest. In other words, if you “want me to change my behavior, I must be confident that in doing so there will be meaningful benefit.” The socio-technical science of healthcare reliability can be embedded inside the organization to transform education (knowledge) into meaningful improvement (action).
Apply HCRO Across All Departments and Functional Areas
This approach must be systematically applied across all departments and functional groups within the healthcare organization. The process often can begin with Human Resources, Quality, Risk and Patient Safety departments, and expands to include all operating departments and ancillary service groups. Physicians, both employed and non-employed, are critical to HCRO success.
Deeper dives in understanding HCRO principles, combined with advanced tools and methods will yield near-term benefits in targeted areas of improvement, including both process and outcome measurements.
Implement HCRO Reliability Management System™ (RMS)
The final phase for HCRO practice is to develop an organization-wide Reliability Management System™. Pioneered by HCRO Cohorts and trademarked under HCRO, this enterprise tool becomes the visible means of identifying real-time reliability, department-by-department. It’s an innovative way of documenting how reliable we are at any given time in our ability to 1) identify and understand risk, 2) develop resilient systems and 3) improve practice behaviors to manage these risks, and 4) sustain all of these HCRO strategies over the long-term.
In our next article, we’ll respond to the question “How will we know if our organization is ready for the HCRO journey?” and describe the typical amount of time and resources it takes to achieve HCRO recognition. We’ll discuss the value of pre-Cohort assessments and contrast our strategy with traditional approaches to performance improvement.