For Better Care, Break the Rules: 5 Tips to Get Started

Becker's Clinical Leadership & Infection Control (01/08/18) Bean, Mackenzie

Breaking rules is key to improving clinical and administrative processes, according to patient safety experts participating in a Dec. 13 session of the Institute for Healthcare Improvement's (IHI) National Forum on Quality Improvement in Health Care in Orlando. Some rules can cause excessive administrative burdens and unnecessary complexity at healthcare organizations, said Saranya Loehrer, MD, IHI's head of the North America region. Loehrer discussed an IHI initiative, "Breaking Rules for Better Care Week," rolled out in January 2016, that called on 24 healthcare organizations from the IHI Leadership Alliance to solicit feedback on healthcare rules from staff and patients. The organizations asked, "If you could break or change any rule in service of a better care experience for patients or staff, what would it be?" IHI collected unique 342 rules to break, which generally fell into rules that needed clarity, rules that needed redesign, and rules that needed advocacy. When looking to break rules at their organizations, healthcare leaders should be comfortable with discomfort, start small, spark staff interest, offer numerous methods for feedback and prioritize rules to break. A breaking the rules program's message must be provocative, said Amelia Brooks, IHI's director of patient safety and the European region. "If we're not feeling uncomfortable, we won't achieve a significant enough change for us to notice something different in our system," she said.

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