If you ask anyone what they expect from a hospital experience, they will likely tell you three things: “Keep me safe. Make me better. Treat me with kindness and compassion.” 

Keeping patients safe is a crucial aspect of health care that involves minimizing the risk of errors, accidents and other adverse events that can occur in health care settings.

While health care organizations have made strides in the area of patient safety and preventing avoidable harm, the reality is that patient harm still occurs in Canadian hospitals and hospitals around the globe.

In a recent report published by the Canadian Institute for Health Information and Healthcare Excellence Canada, it was revealed that 1 in 17 hospital stays in Canada involved at least one harmful event.

“Preventable harm is a challenge that hospitals across Canada and the globe face almost every single day,” says Altaf Stationwala, Mackenzie Health’s President and CEO. “This can be attributed to multiple factors including human error, technological challenges and unclear processes and procedures.” 

Health care settings consist of complex systems with professionals operating in high-volume, high-stress environments. So what are hospitals doing to mitigate some of the risks that come with such conditions?

For Mackenzie Health, embarking on a journey to zero harm in November 2019 was the organization’s way of making a commitment to actively promote a culture of transparency, accountability and continuous improvement in order to prevent harm and ensure the best possible outcomes for patients. 

To shift quality and safety from principles to practice, Mackenzie Health was committed to operationalizing the zero harm philosophy by introducing system-wide changes. 

When they embarked on their journey to zero harm to become a high reliability organization, they developed a five-part strategy for cultural and process redesign using evidence informed methods including: engaging stakeholders and leveraging leadership support, developing a quality and patient safety framework, selecting meaningful organizational quality aims, evolving the safety review process to enhance reporting and learning and creating a comprehensive communication plan3. This strategy set the stage to improve the patient safety culture within the organization.

“We maintained our focus on safety and quality as a way to mitigate clinical risk in a highly turbulent COVID-19 environment – a time when the system was challenged to deliver basic care,” explains Mary-Agnes Wilson, Executive Vice President, Chief Operating Officer and Chief Nursing Executive. “We were also in the midst of opening Cortellucci Vaughan Hospital, initially as a system solution to treat COVID-19 patients, and recruiting large numbers of new staff. Despite all the challenges and changes in our environment, we stood firm in our commitment to safety and have seen substantial clinical success.”

While significant improvements across areas of quality, safety, experience and workforce engagement were made over a span of three years, Mackenzie Health didn’t stop there1,2,4.

To accelerate its zero harm journey and advance quality and safety in pursuit of patient care excellence, the organization made the choice to invest in implementing High Reliability Organizing (HRO) principles – principles used in industries like the aviation and nuclear industries where the stakes are high and errors can lead to catastrophic outcomes. This includes outlining the reliability and service excellence behaviours and tools needed to continue building on its culture of safety, with a focus on compassionate and patient-centred care.

“By equipping them with highly effective learning behaviours and tools, we are empowering and enabling every single person at Mackenzie Health to provide reliable and consistent care to every patient, every time,” stated Altaf Stationwala. “Mackenzie Health will continue to prioritize safety efforts such as implementation plans that include training, accountability mechanisms and effectiveness monitoring to ensure patient safety is always at the forefront of everything we do.” 

As a testament to this major investment in patient safety, Mackenzie Health was recently named the winner of the Canadian College of Health Leader’s 2023 Excellence in Patient Safety Award. This prestigious award recognizes individuals and teams that are committed to transforming and improving patient safety within a health care environment, through leadership, culture change, quality improvement, patient partnership and innovation.

It is reported that organizations who commit to adopting HRO skills as practice habits can reduce their serious safety event rate by 80 to 90 per cent within the first two years. Enhancing patient care starts with adopting and maintaining a culture of safety by being open and transparent about current challenges, continuously assessing existing processes and systems that are not optimized for safety, and introducing system-wide changes and practices to support health care professionals perform reliably every time. 

As part of their 2022-2025 strategic plan, Mackenzie Health is focusing their efforts on transforming quality and safety through the pursuit of highly reliable care – a continuous journey that will help the organization to continue to deliver excellent care to its communities. Maya Sinno is the Director, Quality Patient Safety and Patient Experience and Léa Salameh, Senior Communications Consultant, Mackenzie Health.