Applying Quality Management in Healthcare

Organizations in industries outside of health services that are most commonly identified as tightly coupled include nuclear power plants and aircraft carriers (Roberts 1990). Health services, however, are not contained within a single organization; rather, services are provided by a complex variety of interdependent organizations (i.e., social structures; see Chapter 1). Within these organizations, nested structures such as departments, divisions, and professional groups are also present. Social organizations are generally considered to be “complex and loosely coupled” (Scott 2003, 83); however, the tasks carried out by the organizations may often be considered tightly coupled. For example, surgeons, anesthesiologists, and nurses may belong to separate, distinct, loosely coupled departments within the structure of the organization, yet, when they come together in the operating suite, the tasks involved in conducting a surgical procedure are tightly coupled. An undetected mistaken patient identity or incorrect surgical site can quickly lead to disastrous consequences if not identified prior to surgery.

• According to your readings in this chapter – what organizations have developed what tools to promote safe clinical outcomes?

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