Comparison of High Reliability Theory and Normal Accident Theory - Coursework Example

Compare and contrast high reliability theory and normal accident theory Compare and contrast high reliability theory and normal accident theory Introduction Patient well-being includes the processes that protect them from harm triggered by medical negligence. Certifying patient protection requires ready systems and developments that maximize the probability of avoiding adverse health check proceedings (Institute of Medicine, 1999). This paper presents Compare and contrast high reliability theory and normal accident theory Patient safety Patient safety is a recent healthcare regulation that highlights the coverage, analysis, and avoidance of clinical error often controls to unfavorable memorable techniques (Aspden 2004). The safety undertaking in health maintenance can be depicted as being undeveloped for many years, with unstable importance and development arising in the 1990s (Corrigan, Cohn and Donaldson, 1999). Though first do not impair has been the main controlling principle for doctors, there are several legal, social, logistic, and other obstacles to gaining an honest assessment of the level of unnecessary patient damages and fixing something near the understanding expanded. Several of strengths joined in the past fifteen years to categorization these obstacles and interrogate outlaws (Vincent, 2001). These influences include a persistent drive for fee control by payers, modifications in social values that are influencing decision-making specialist to patients and sets of stakeholders (Vincent and Coulter, 2002). Patient protection attempt has delivered new understandings into health care work developments and new apparatuses to aim the improvement attempts. Staff members have come to appreciate that the exceptional developments in medicine and scientific technology should be joined with invention in the administration system paradigms they use to care and provide patient maintenance. They also appreciate that the determinations cannot be suspended, as the scarcity of care to provision model and development is conceding the quality of maintenance (Wade, 2003). Patient well-being is a national health care disputes. A report prepared by the Institute of Medicine approximates that 44,000 to 98,000 patients die in hospitals every year as an outcome of failures in patient care (Studdert and Brennan, 2001). Patient safety is a grave worldwide community health problem. Approximations show that in advanced countries ten patients are injured while getting hospital treatment (Reason, 2000). In third world countries, the possibility of patients being injured in hospitals is sophisticated than in developed nations. The jeopardy of wellbeing-associated contamination in some third world countries is twenty times in developed countries (Boyer, 2001). Main discussion of high reliability theory and normal accident theory Organizational aspects play a part in nearly all mishaps and are a dangerous part of interpretation and averting them. Two conspicuous sociological groups of thinking have tackled the managerial aspects of protection: Normal Accident Theory and High Reliability Organizations (Boyer, 2001). Unfortunately, the school of thought believes that these methods have debated about each other since they fail to explain important ideas and identify significant differences (Boyer, 200). Researcher believe that the argument between HRO and NAT can turn out to be a practical conversation by embracing a systems tactic to safety developing from manufacturing disciplines (Reason, 2000). The comprehensive organizations approach explains the NAT and HRO strengths and weaknesses and proposes a broader collection of analytic instruments and involvement strategies to handle risk. This method is of precise value in tackling the difficult interdependencies and complete causes related to risks in modern society (Reason, 2000). Therefore, high reliability theory and normal accident theory are organizations of theory, investigation, and commendations for practice and procedure that progressed essentially in corresponding. Therefore, there are occurrences where these methods differ in their moulds and in the structural features, they handle as significant, rather than contribution challenging hypotheses (Reason, 2000). Every frame presents significant inquiries and offers valued perceptions into the search of patient protection. Previous research studies contrasted the two perceptions by using them to tragedies, but medics use them to five general patient protection practices (Reason, 2000). They mainly aimed at identifying idiosyncratic influences that NAT and HRT create to identification the administrative conditions touching patient protection in infirmaries and the possibilities for changing health care setting into HROs (Snook, 2000). NAT presents its past original structure, which includes procedures and communications between units and personalities. Furthermore, it is used to provide an understanding of instances and constituent failure misfortunes in hospitals (Reason, 2000). Looking at the hospital perspective, HRT claims that other groups pursuing to achieve high consistency in their settings can recognize the descriptions of HROs and implement them (Robert, 1990). On the other hand, NAT researchers uncover lasting and intrinsic risks in dangerous activities; they mention uncertainties whether the perfect HROs in manufacturing industries require imitation by other organization (Thomas and Helmreich, 2002). One approach to picture this discussion will be to view NAT inventors as opponents of HRT; in that they mention apprehensions about descriptions like severance, training, and a combined safety philosophy which HRO specialists put extensive trust (Weick and Sutcliffe, 2001). Another opinion would acclaim HRT for sketching attention to the area of public understanding and philosophy (Tucker and Edmundson, 2003), while NAT complements alertness of the belongings on protection of organization features as well as connection, interactive complication, and policies (Sagan, 2004). Coupling indicates to the level of requirement among organization constituents like, procedures, apparatus, and the individuals who control them. Collaborating complexity is the level to which relations among like components are unanticipated, accidental, or not observable (Sagan, 2001). NAT and HRO disputes sometimes appear in the bottom up or top down argument. Individuals who exist with high reliability understand it as a centrifugal movement and centripetal away from the occurrence (Sagan, 2001). Communication runs from the incident, towards the administration’s center for handling. Action shifts towards the incident, away from dominant authority, to interrelate with the condition. One can get to know what functions through conflict and the reaction to the activities expresses the formation of the crisis (Sagan, 2001). NAT claimed that one cannot see everything concerning these complicated and dangerous machineries, and consequently the accidents people see are usual and unavoidable (Sagan, 2001). HRO claimed that particular organizations happen to have very sporadic problems even with daunting risks; therefore they should be organizing the right thing. This question could be put across to distinguish the features of the two (Sagan, 2001). The Berkley Group established the theory of High Reliability in the 1980s as a reaction to Perrow’s unenthusiastic assumption that misfortunes are unavoidable or normal in organizations that are complex and strongly joined (Roberts, 1990). Contrary to high reliability theory, it recognizes that other groups are able to successfully work in such surroundings and attain an evidence of reliable care over a given time (Roberts, 1990). An assortment of important descriptions have been recognized that are thought to be the characteristic of HROs, as well as nominal expertise, even technical developments, a high importance placed on security, attention to difficulties, and a learning adjustment (Roberts 1990). Weick and Sutcliffe (2001) have also proposed five codes of HROs: concern with disappointment, unwillingness to simplify explanations, sensitivity to actions, commitment to strength, and deference to involvement. Other researchers have also proposed new clarifications, terms, and the choice of asserted high reliability theories are now massive (Vincent, 2001). Several researchers have claimed that the philosophies of HRO depends on the context (Waller and Roberts, 2003) and warning that the philosophies and exercises that appeared from the theory should be used as frameworks and not as outlines and they need to be verified empirically through extensive research and action (Tamuz and Harrison, 2006). A lot of research needs to be conducted to assist organizations to categorize HRO attempts that mount their particular context. HRO research originally involved US Merchant marine carrier flying, the National Aviation Management’s air traffic power controls (Schulman, 1993), business-related nuclear plants and offshore podiums (Bea, 2002). Lately, researchers have claimed that HRO concept is appropriate in normal, low threat situations (Zohar and Luria, 2003). They also give a need for consistent presentation like the police department, guide procedures and railway lines, provision of electricity, software compacts, investment, microcomputer companies, vocational schools, and technological systems (Busby, 2006). Researchers have also approved the latent worth of HRO to hospitals because the surroundings and confronts are comparable (Hudson, 2003). As noticed by Vincent (2010), research of high reliability theory has fortified optimism around what can be accomplished in hospitals and directed to a practical approach to care than available reactive knowledge from occurrences and hostile measures. High reliability theory has the following significant disadvantages (Vincent, 2010); 1) Though previous research studies focus on an extensive range of features said to be significant to care and consistent implementation, the features are not well defined in terms of their importance in diverse settings 2) Limited studies center on HRO application. A small amount is identified about the arrangement of openings and obstacles that result from in such surroundings, the required competences of persons responsible or the implementation process 3) The subject has continued to be definitely descriptive with insufficient efforts to calculate the features of high reliability groups or link them to practical safety consequences The Normal Accident Concept was provoked by the three miles nuclear power plant accident. This concept holds that as structures become complicated, accidents turn out to inevitable or ordinary (Perrow, 1999). The dimensions of cooperating complexity and connection determine the vulnerability to mishaps in these difficult administrations. A mishap is described as an event in which unimportant loss arises (Perrow, 1999). An event is an unanticipated or unsolicited change in procedure that has the latent to trigger an injury (Perrow, 1999). Accidents are categorized as a tragedy when an individual dies or wide property destruction or lose of money (Perrot, 1999). According to this theory, protection is one of competing purposes of the theory (Perrot, 1999). Idleness often instigates accidents. It enlarges interactive complication and opacity and inspires taking of risk. In terms of organizational inconsistency- devolution is needed for complication and time reliant on decisions, but control is desirable for strongly coupled schemes. A philosophy of reliability is deteriorated by reduced responsibility. Groups cannot guide unimagined dangerous events or political disgusting operations. NAT emphases mainly on two descriptions of an organization: the difficulty of communications between the elements of system, and the occurrence of tight connection between the elements of a system (Perrot, 1999). An organization is closely joined when a variation in one portion of the organization quickly changes other portions of the organization. For instance, certain physiologic arrangements are safeguarded from alterations in others, while certain central constituents, like oxygen distribution and blood movement, are strongly joined together and interrelate intensely. The patients compositions strongly join to external structures like ventilators and blends of thermodynamically effective medications. When difficulty and tight connection coexist, irregular sequences of incidents can be unseen and have complicated or volatile consequences. Characteristically, active inaccuracies in the structure do not end in a mishap because they are confined at in the systems numerous levels of inspections and resistances (Perrow, 1999). NAT scientists recognize that event-reporting organizations can offer the feedback groups need to study from their practice, although they seem to be negative that groups will prosper in adjusting their inner reward structures to endorse free event reporting and discovering (Perrow, 1999). The societal costs of misfortunes make studying very significant; the theories of blame, though, make studying very problematic (Sagan, 2004 p. 238). Dangerous organizations frequently do not make motivations for entities to report their mistakes or for sections to share event statistics with others. In spite of these problems, Air Company has established innovative approaches of reducing discouragements for event reporting. Those individuals who make reports are protected from company corrective procedures and full controlling prosecution (Tamuz 2000). Conclusion Each structure can make an important contribution to refining patient care. By using the NAT and HRT frameworks, medical care scholars and managers can recognize hospital backgrounds in which innovative and present patient protection involvements are likely to be real. Additionally, they can get advance the patient well-being measures, not only by learning the organizational significances of applying safety actions from studying mishaps, but also by leaning the structural consequences of executing safety methods. Lastly, both NAT and HRT emphasize on the significance of learning from mistakes and near errors. Nevertheless, the supporters of the two standpoints differ in their evaluation of the possibility of gathering evidence about these securities -related actions and acquiring from them. References Aspden P, et al, eds, 2004. Patient Safety: Achieving a New Standard for Care. Washington DC: National Academies Press. Bea, R. 2002. Human and Organizational Factors in Risk Analysis and Management of Offshore Risk Analysis, 22, 29-45. Boyer, M.M., 2001. “Root Cause Analysis in Perinatal Care: Health Care Professionals Creating Safer Health Care Systems” The Journal of Perinatal and Neonatal Nursing 15(1): 40-54. Busby, J. S., 2006. ‘Failure to Mobilize in Reliability-Seeking Organizations: Two Cases from the UK Railway’. Journal of Management Studies, 43, 1375-1393. Structures. Corrigan J., Cohn L, Donaldson M, eds, 1999. To Err is Human: Building a Safer Health System. Washington DC: National Academies Press. Hudson, P. 2003. ‘Applying the lessons of high risk industries to health care’. Qual Saf Health Care;12(suppl 1):i7-12. Institute of Medicine, Ed, 1999, ‘To Err Is Human.” Washington, National Academy Press. Perrow, C., 1999. Organizing to Reduce the Vulnerabilities of Complexity’. Journal of Contingencies and Crisis Management. 1999b; 7(3):150–5. Reason, J., 2000. “Human error: Models and management.” British Medical Journal. 320 (7237): 768-70. Robert, K. H. 1990. Some characteristics of one type of high reliability organization. Organization Science, 1, 160-176. Sagan, S. D. 2004. Learning from Normal Accidents. Organization and Environment. 17(1):15–9. Schulman, P. (ed.) 1993. The Analysis of High Reliability Organizations: A Comparative Framework. In:Roberts, K. H. New Challenges to Understanding Organizations. New York: Macmillan. Studdert, D. M. and Brennan, T. A. 2001. “No-fault compensation for medical injuries: The prospect for error prevention.[comment].” Journal of the American Medical Association. 286 (2): 217-23. Tamuz M. 2000, Defining Away Dangers: A Study in the Influences of Managerial Cognition on Information Systems. In: Lant T K, Shapira Z, editors. Organizational Cognition: Computation and Interpretation. Mahwah, NJ: Lawrence Erlbaum Associates; 2000. pp. 157–83. Tamuz M, Harrison M. 2006. ‘Improving patient safety in hospitals: contributions of high-reliability theory and normal accident theory’. Health Serv Res 2006; 41:1654-76. Thomas E J, Helmreich R L, 2002. ‘Will Airline Safety Models Work in Medicine? In: Sutcliffe K M, Rosenthal M M, editors. Medical Error: What Do We Know? What Do We Do? San Francisco’: Jossey-Bass. pp. 217–34. Tucker A L, & Edmundson, A C., 2003. Why Hospitals Dont Learn from Failures: Organizational and Psychological Dynamics that Inhibit System Change. California Management Review; 45(2):55–72. Vincent, C. 2001. “Clinical risk management: Enhancing patient safety.” London, British Medical Journal Publishing Group. Vincent, C. A. and A. Coulter, 2002, “Patient safety: What about the patient?” Quality & Safety in Health Care, 11(1): 76-80. Wade, J. G., 2003. “Patient safety in anaesthesia – continuing challenges and opportunities.” Canadian Journal of Anaesthesia 50 (4): 319-322. Waller, M. J., And Roberts, K. H. 2003. ‘High reliability and organisational behaviour: Finally the twain must meet’. Journal of Organizational Behavior, 24, 813-814. Weick, K. E, Sutcliffe, K.M., 2001. Managing the Unexpected: Assuring High Performance in an Age of Complexity. San Francisco: Jossey-Bass. Zohar, D. & Luria, G., 2003. ‘Organizational meta-scripts as a source of high reliability’: The case of an army armored brigade’. Journal of Organizational Behavior, 24, 837-859. Read More