Beyond Compliance: Taking a high reliability approach to quality and safety

High reliability supports organisations to strive towards consistent and excellent outcomes in quality and safety. Despite high reliability being widely utilised in healthcare, little is known about its application specifically to aged care.

This presentation explores the beginning of the high reliability journey that Regis Aged Care is taking across its national portfolio of 63 aged care homes.

This implementation approach is organised around five domains for change:

1. Leadership commitment to high quality, safe care – We have placed a significant emphasis on creating and defining our vision for high quality care and implementing effective clinical governance systems to support this. A particular focus has been on strengthened partnerships with consumers at both a Home and organisational governance level. Our Consumer Advisory Committee, implemented in 2022, has been a key enabler in driving our quality and safety culture forward.

2. A data driven approach – Efforts to date have focused on ensuring reliable and valid data collected and reported in the easiest way possible. We have introduced statistical process control charts into governance reporting, and coached our leadership teams on the principles of variation.

3. Standardising the safety operating system – We have focused on our systems around incident management and investigation. We have introduced an incident severity matrix, tiered investigation process, incident taxonomy, root cause analysis (RCA) methodology and the London Protocol contributing factors framework. We have introduced a Clinical Incident Review Committee to openly and transparently share learnings from serious incidents. We conduct human factors and RCA training.

4. Enabling staff to improve – We have implemented a training program to support staff capability in improvement. This is delivered over two intensive days and is followed by 8 weeks of improvement coaching to assist the participant with applying the improvement tools and techniques learnt to a workplace problem. The training covers a broad range of areas including PDSA, six sigma and lean.

5. Targeting interventions to address safety issues – We have implemented a deep dive methodology to better understand areas of highest impact and risk. We have used different improvement tools to understand where failures can occur and what interventions are required for improved safety. This has included deep dives into falls, COVID mortality, wound management and sexual assault.

Whilst we know it will not happen overnight and our journey will be long, we are committed to our pursuit of becoming an High Reliability Organisation.