Abstract :
Management of quality and safety (MQS) in the industrial systems is a cornerstone of high reliability organizations (HRO´s). These HRO´s are relentlessly coping with a high intrinsic risk, do function with success and achieve high performance levels and handle the safety issue systematically and systemically. In the Health Care Sector (HCS), there is at the start resistance to consider it as an “industrial system” although it responds to all the basic characteristic of the “system” as defined by von Bertalanffy. This cultural particularism is one of the major reasons for the “pandemic” outbreak of iatrogenic accidents (i.e. induced by the system failures). In 2013, John James from Patient Safety America, report at least 400´000 death yearly in the hospital sector in the USA which are due to system failures. What basically differentiates industrial HRO´S from the HCS is the integrated quality management (IQM). IQM is according to the National Association of Healthcare Quality, a planned, systematic approach to the monitoring, analysis, and correction and improvement of performance, which increases the likelihood of desired outcomes by continuously improving the quality of care and services provided. All too often, the workers in the HCS are with their nose in the grindstone and do claim they have “no time or money” to dedicate to what does not seem priority. Moreover, as they do not accumulate data on the performance of the system they do lack situational awareness. In 2008, the radiotherapy service at CHU-Liège, decided to be trained by safety officers issued from civil aviation in methodologies to improve safety and operational performance. To structure the long way to excellence, the generic model of the European Foundation for Quality Management was adopted. To motivate the “ecosystem” to adopt this for the HCS unnatural approach, the leader decided in 2009 to participate to the regional contest in Wallonia taking place every 2 years (MWQ = Mouvement Wallon pour la Qualité, based on the EFQM-model). The basic advantage of this “transversal” benchmark, is rapidly gaining expertise and knowledge from other sectors. In 2015, the last level of the four at MWQ is underway and the department did obtain the first prize at level one, two and three. This is a hard time for leadership as in the HCS there are 5 very resistant myths of medical infallibility: medicine is something “special” and cannot be compared to industry, MD´s are totally free in a well-known and mastered environment, extensive theoretical knowledge is an excellent safeguard against error, hierarchical structure is an excellent safeguard against error, SOP´s and standards restrain MD´s in using their professional skill. Because of the observed pandemics and its enormous economic burden on society, it is high time to provoke a cultural earthquake in the HCS and to embrace at large IQM.
Keywords :
"Hospitals","Cultural differences","Quality management","Head","Safety management"
