Abstract
The movement toward demonstrable quality and value in medical care is on a fast track because payers, weary of mediocre service, are tying payment to the reliability of excellent outcomes. The challenge for healthcare leaders is increasing as complexity and poor management causes variation in care with extraordinary medical error rates. Highly reliable work environments have specific characteristics. Leaders must embrace values of non-negotiable respect and appropriate accountability. Teamwork training is essential as is ongoing measurement of cultural indices. A linked strategy, structure and execution is necessary. This paper describes the steps to achieve a learning and reliable healthcare culture.
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