Archive ORX Session Previews 2018

High Reliability for a Highly Unreliable World

Controlling what you can control ensures inevitable human errors never result in patient harm.

Spence Byrum

Spence Byrum, CEO


Spence Byrum
Spence Byrum, HRS Consulting Weston, Fla.

Many things conspire against you before a patient even walks into your facility, says Spence Byrum, CEO of HRS Consulting, a human performance improvement company. Time, patient, employee and equipment constraints are just part of the unreliable world we live in. Instead of worrying about the things that you can't control, Mr. Byrum will show you how to focus on the things you can control and how to turn your facility into a high reliability organization.

  • What is a High Reliability Organization (HRO)? An HRO is an organization that operates in a very high-risk environment where the cost of a significant error can be catastrophic, if not fatal. Leaders of HROs standardize the things they can control so they can save brain power for the things they can't.
  • Key elements of HROs. As a Coast Guard pilot, Mr. Byrum always had a procedure or plan in place for any situation — whether flying into a hurricane or a blizzard. He'll show you how the best practices outside of health care can be incorporated into and bolster the best practices within health care.
  • OODA loops and why they are critical to reliability. You'll get real-life examples of areas where HRO has been applied with success both in and out of the healthcare setting. Mr. Byrum will discuss how you can apply the observe, orient, decide and act (OODA) loop deployed by the military to the healthcare setting.
  • Surgery in the VUCA-T environment. You work in a VUCA-T environment (Volatility, Uncertainty, Complexity and Ambiguity-Threats). Many things come up during the surgical experience that you may not foresee — missing equipment, staff not ready on time or the patient didn't fill out his paperwork beforehand. Standardizing protocols in the areas you can control has worked for other high-risk companies such as those in aviation and nuclear power. It can work for you, too.
  • Cool under fire. If you're under stress, you can't make good decisions. HRO gives you ways to control what you can so your brain is primed to deal with the challenging decisions you make every day. Mr. Byrum will discuss how applying these HRO strategies will produce better outcomes for your patients.

"Health care demands that we get it right the first time," he says. "It is our moral obligation to significantly decrease the chance for harm." OSM

  • Chief Executive Officer of HRS Consulting, a human performance improvement company created to enhance decision making in high-risk industries.
  • Former Coast Guard rescue pilot and an internationally known expert on the subject of human performance in challenging, time-critical environments.
  • Has reviewed more than 1 million near-miss and sentinel events and is an expert in evaluation of the causal factors and remediation of their impact.
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