David A. Spahlinger, M.D.

News & Research

The Path to High Reliability

How Michigan Medicine is becoming a “highly reliable organization”

Summer 2019
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Health care providers across the country do amazing work to help promote and advance health care. However, as much as we prioritize safety and quality, we still make mistakes. It is estimated that more than 250,000 people in the U.S. die each year from medical errors, making it the third leading cause of death after heart disease and cancer. Without question, the most important reason to focus on this issue is to ensure the safety and well-being of our patients. In addition, it is worth noting that preventable medical errors in the U.S. alone account for nearly $20 billion in medical bills. With the rising cost of health care, we could make a significant impact by reducing medical errors and preventable injuries.

To do so, Michigan Medicine is embarking on a journey to become a “highly reliable organization.” The concept of high reliability originated in complex industries such as commercial aviation and nuclear power, where intricate systems increase the likelihood of accidents and adverse events. A highly reliable organization depends on its people and certain behaviors, tools, and techniques to consistently avoid potential errors and, subsequently, poor outcomes.

Over the next several years, we will focus on developing the universal safety skills that highly reliable organizations possess and practice. These include fostering better communication skills that further teamwork and respect among colleagues. It also means adopting practices to cross-check work, validate and verify processes, and identify potential red flags. All of these improvements, while seemingly simple, will collectively create a stronger safety culture where our employees are our first line of defense against mishaps and errors.

This journey to high reliability will engage all of our employees, even those who don’t work directly in the patient care setting. It is just as critical for the IT staff who administer our electronic medical records, the analyst who manages supply chain inventory, and the financial adviser who implements payment plans to develop the mindset and skills of a highly reliable organization. The work they do, in some direct or indirect way, impacts and informs key decisions about a patient’s care and the experience they have with us.

As health care becomes increasingly complex, we must find new ways to improve our quality, reduce harm, and manage costs. Sometimes that means learning and taking best practices from other diverse industries that have similar levels of complexity. It is the right thing to do, both for our bottom line and for the well-being of the patients who entrust us with their care.

David A. Spahlinger, M.D.
Executive Vice Dean for Clinical Affairs
President of the U-M Health System
Clinical Professor of Internal Medicine