Sana Tamim1, Syeda Shazia Adeel2, Tim Trevan3, Aamer Ikram1, Nadira Jadoon4, Ayesha Zaman5, Rashid Mehmood6, Qazi Muhammad Ashfaq6, Atifa Mushtaq6, Maria Shaukat7, Mehak Nimra7, Saima Hamid8, Iqra Shabbir8. 1. Department of Virology/Immunology, National Institute of Health, Islamabad, Pakistan. 2. Quality Assurance Department, National Institute of Health, Islamabad, Pakistan. 3. Chrome Biorisk Management Consulting, Washington, District of Columbia, USA. 4. Department of Hematology, National Institute of Health, Islamabad, Pakistan. 5. Department of Microbiology, National Institute of Health, Islamabad, Pakistan. 6. Drugs Control and Traditional Medicine Division, National Institute of Health, Islamabad, Pakistan. 7. Biological Production Division, National Institute of Health, Islamabad, Pakistan. 8. Nutrition Division, National Institute of Health, Islamabad, Pakistan.
Abstract
Introduction: Healthcare organizations are complex systems where healthcare professionals, patients, biological materials, and equipment constantly interact and provide feedback with highly consequential outcomes. These are the characteristics of a complex adaptive system. Healthcare delivery requires coordination but it necessarily relies on delegation of essential functions. It is thus essential to have an engaged workforce to ensure optimal outcomes for patients. Thus human performance factors play a key role in ensuring both the presence of excellent healthcare provision and the absence of outcomes that must be avoided-"never events." Methods: The commitment of management was a precondition for the implementation of the high-reliability organization (HRO) principles. A team from middle management was engaged and provided with appropriate management tools for identifying, prioritizing, assessing, and applying solutions for the safety concern in their operating systems. Results: This article documents efforts at the National Institute of Health (NIH) to adapt the principles of HROs to diagnostic laboratories and vaccine production facilities at its campus in Islamabad, Pakistan, and seeks to draw some lessons for how this approach can be usefully replicated in such facilities elsewhere. Conclusion: Public health institutes such as NIH deliver vital products and services that are inherently risky to produce, where the consequence of failure can be catastrophic. Adopting the HRO principles is an approach to improving not just safety, but also the overall organizational performance in any setting, including low-resource settings, and can serve as an implementable process for other institutions. Copyright 2022, ABSA International 2022.
Introduction: Healthcare organizations are complex systems where healthcare professionals, patients, biological materials, and equipment constantly interact and provide feedback with highly consequential outcomes. These are the characteristics of a complex adaptive system. Healthcare delivery requires coordination but it necessarily relies on delegation of essential functions. It is thus essential to have an engaged workforce to ensure optimal outcomes for patients. Thus human performance factors play a key role in ensuring both the presence of excellent healthcare provision and the absence of outcomes that must be avoided-"never events." Methods: The commitment of management was a precondition for the implementation of the high-reliability organization (HRO) principles. A team from middle management was engaged and provided with appropriate management tools for identifying, prioritizing, assessing, and applying solutions for the safety concern in their operating systems. Results: This article documents efforts at the National Institute of Health (NIH) to adapt the principles of HROs to diagnostic laboratories and vaccine production facilities at its campus in Islamabad, Pakistan, and seeks to draw some lessons for how this approach can be usefully replicated in such facilities elsewhere. Conclusion: Public health institutes such as NIH deliver vital products and services that are inherently risky to produce, where the consequence of failure can be catastrophic. Adopting the HRO principles is an approach to improving not just safety, but also the overall organizational performance in any setting, including low-resource settings, and can serve as an implementable process for other institutions. Copyright 2022, ABSA International 2022.