Compliance and High Reliability in a Complex Healthcare Organization

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SUMMARYWhen considering the impact of regulation on healthcare, visualize a spider's web. The spider weaves sections together to create the whole, with each fiber adding to the structure to support its success or lead to its failure. Each section is dependent on the others, and all must be aligned to maintain the structure. Outside forces can cause a shift in the web's fragile equilibrium.The interdependence of the sections of the spider's web is similar to the way hospital departments and services work together. An organization's structure must be shaped to support its mission and vision. At the same time, the business of healthcare requires the development and achievement of operational objectives and financial performance goals. Establishing a culture that is flexible enough to permit creativity, provide resiliency, and manage complexity as the organization grows is fundamental to success. An organization must address each of these factors while maintaining stability, carrying out its mission, and fostering improvement.Nature's order maintains the spider's web. Likewise, regulation can strengthen healthcare organizations by initiating disruptive changes that can support efforts to achieve and sustain high reliability in the delivery of care. To that end, leadership must be willing to provide the necessary vision and resources.

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