On September 10, the Association of the United States Army held a medical symposium that discussed military medical needs and concepts for new approaches to care. The symposium--held close to the Pentagon--featured Gen. Daniel B. Allyn, new Vice Chief of Staff, and Lt. Gen. Patricia Horoho, Army Surgeon General, as key speakers.
Although the theme for the day was "Strengthening the Health of Our Nation by Improving the Health of Our Army," Allyn, the opening speaker, provided the focus for the symposium when he said that the reason the group was there was to discuss the Army's future and prepare for Force 2025 and beyond.
The discussions that followed focused on the future of Army Medicine. Horoho discussed how technology advancements in Army Medicine will be a key part of how our healthcare will continue to improve. At the heart of our pursuit of excellence, she said, is becoming a high-reliability organization (HRO).
HROs meet the standards for their industry by having well-established policies and systems in place that ensure consistency of practice and enable them to reach their goals and avoid errors.
Examples of industries that could not function without being comprised of HROs include nuclear power and air travel. High reliability are critical to operations for these industries--there is no room for failure--and important for consumer trust.
As part of preparing Army Medicine for the future, the issue of becoming an HRO is directly linked to reducing medical harm. Horoho made it clear that Army Medicine had a commitment to a culture of patient safety and there would be no compromise.
Reasons for becoming an HRO are as complex as an HRO itself. HROs exist in complex environments with multi-faceted teams that must coordinate their efforts to ensure patient safety. The safety of a hospitalized patient depends on the effective communication of a number of clinical and technical personnel--from the surgeon to the lab tech. A well-coordinated team is critical for an HRO to ensure patient safety.
Accountability for actions, especially if an error has occurred, is especially important because errors can result in severe consequences.
Decision-making is critical for an HRO to function well. During a crisis, decision making is deferred to the most knowledgeable person on the team; however, there often is more than one decision maker, and each decision can impact the next. As a result, decision makers must communicate effectively.
Finally, frequent feedback drives changes in an HRO. The continuous adjustments based on feedback allow staff to anticipate and avoid medical errors.
Unfortunately, Horoho said, most evidence indicates that the number of medical errors is not being reduced. In fact, medical errors seem to be increasing in hospitals across the United States.
Nevertheless, she reported that positive changes in attitudes and behaviors are becoming "embedded in the DNA of our Army." Those improvements, she said, can be seen in our health, resilience, readiness, and performance.
Just as Army Medicine is becoming one of the nation's leaders in improving the healthcare of its families, Army Medicine can also become the nation's leader in creating a culture of safety in medical care, she said.
Our Soldiers, our Families, and our Retirees will always need excellent healthcare, as does the entire Nation, Horoho said. "We must not accept anything other than zero harm."
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