Bridging the Academic/Practitioner Divide: Toward Highly Reliable Health Care

1. Bridging the Academic/Practitioner Divide:Toward Highly Reliable Health Care Timothy J. Vogus Vanderbilt Owen Graduate School of Management April 19, 2011

2. Academics and Practitioners See the World Differently Specific General Implicit Practitioner Explicit Academic Adapted from Dutton & Starbuck (1963)

3. How HRCM Helps • Creates forums for extended conversation • At the intersection of theory, research, and practice • E.g., joint academic/practitioner edited volumes to explore a case, a crisis, and set an agenda • Establishes a body of work that cuts across industries

4. HRCM Series – Academic  Practitioner • Make academic more specific • Problem-driven research • Asking and answering important questions for policy and practice in a timely fashion • Practice-oriented • Translating research findings • Giving the story as well as the finding • Elaborate the implications

5. HRCM Series –Practitioner  Academic • Make practitioner intuition explicit • Derive underlying principles from successes and failures • Enables far-reaching collaboration between practitioners and academics • Keeps academics relevant

6. How Do I Try to Bridge the Divide?

7. A Tough Problem • Medical error • IOM’s 1999 To Err Is Human report revealed 98,000 die every year from medical error • Epidemic persists over a decade after (Landrigan, et al., 2010) • Where can we look for solutions? • HROs • How I have studied it • Large-scale survey research • Partnering with a health care organization • Longitudinal study • Participant observation

8. How Might HRO Improve Patient Safety? • Mindful organizing (Weick, et al., 1999) • Spending time identifying what could go wrong • Discussing alternatives as to how to go about everyday activities • Talking about mistakes and ways to learn from them • Taking advantage of the unique skills of one’s colleagues (even if the person is of lower status in the organization) • Mindful organizing allows for the rapid detection and correction of errors and unexpected events

9. Does Mindful Organizing Improve Safety? • Yes! • 35% fewer medication errors on a nursing unit • 7 fewer errors per year per unit • 69% fewer patient falls on a nursing unit • 13 fewer falls per year per unit

10. A Roadmap for Practice • Leadership endorsement • Measure the baseline • Qualitative and quantitative • Use data as the starting point • Enjoin the conversation • Simple and broad-based interventions • The huddle • Safety rounding • Safety action teams • Sustain the conversation and the enthusiasm