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Description
QUALITY
Background
As provision of care reaches a new complexity in pediatric cardiology, programs are called upon to evaluate how they can bring their teams into the future of pediatric cardiac care. High reliability principles support high-quality care and improve outcomes, thus should be embraced to guide continuous improvement. Although much has been written about high reliability in healthcare, it has not been explored within pediatric heart centers. The purpose of this review is to examine high reliability through the lens of a contemporary pediatric heart center, elaborating on key concepts and proposed considerations for maintaining a high reliability heart center.
Methodology
Core principles of high reliability were reviewed: preoccupation with failure, sensitivity to operations, reluctance to simplify, deference to expertise, and commitment to resilience. Recently published recommendations for comprehensive pediatric heart centers were evaluated and categorized, aligning with high reliability principles. Analysis identified additional drivers of high performance that were further explored in the literature. Suggestions for practical application were outlined.
Outcomes
Operationalizing high reliability within a heart center can facilitate prevention of harm and optimize outcomes. Practical application of high reliability requires a shared mental model and aligns teams. Review of literature identified a gap specific to pediatric cardiology and the application of high reliability principles. Thus, we synthesized literature on relevant themes which emerged as suggested facilitators of high reliability within heart center teams. Drivers included interprofessional collaboration, recognition of nursing expertise, psychological safety, and structural empowerment void of hierarchy. Three primary conclusions were derived from this analysis. First, acknowledging culture as the underpinning of all structure and processes allows teams to rebound from failure and supports the mission of rising to exceptional patient challenges. Second, interprofessional collaboration and a flattened hierarchy support a psychologically safe environment, which in turn supports innovation. Third, but of utmost significance, innovative strategies are necessary to retain experienced pediatric nurses, which are essential for high quality patient care across the heart center.
Publication Date
9-27-2024
Keywords
Cardiology, Pediatric Cardiology, Cardiatric Nursing
Disciplines
Cardiology | Pediatric Nursing
Recommended Citation
Torzone, Andrea and Birely, Alexandra, "High reliability pediatric heart centers: Always working toward getting better" (2024). 2024. 9.
https://scholarlycollection.childrens.com/nursing-anf2024/9
Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-No Derivative Works 4.0 International License.
