According to the principles of reliability science, the key to reducing errors isn’t simply to try harder but to put processes in place that make it easy to do the right thing at the right time.
Here are five ways to achieve this.
1. Standardize your approach. Having a well-defined process for each activity (from rooming patients to conducting diabetes checkups) helps ensure that the proper steps are taken each time, regardless of who is doing the work.
2. Use decision aids and reminders. Checklists, flowsheets, and other tools can help you and your staff follow the standardized processes, especially if you can build the reminders into your practice’s systems.
3. Take advantage of pre-existing habits and patterns. Where possible, use established behaviors to improve reliability. For example, if your nursing staff is in the habit of attaching a diabetes encounter form to the chart of any patient being seen for a diabetes checkup, leverage that habit and extend it to other chronic diseases.
4. Make the desired action the default, rather than the exception. For example, you could decide that the default action is to take blood pressure measurements on all adult patients who come in, no matter the reason for the visit, instead of leaving it up to each individual doctor’s discretion.
5. Create redundancy. When used strategically, redundancy can provide a check on your process and decrease errors. For example, to avoid dosage errors from documenting incorrect weight measurements, have your nurses state the patient’s weight when they record it and then ask the patient (or parent), “Is that what you expected?”
Adapted from “Reliability Science: Reducing the Error Rate in Your Practice.”
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