Last Thursday evening I was fortunate to be able to spend time enjoying great food and company and a little wine, talking with clients and colleagues who each have a unique perspective regarding the challenges of managing quality of delivery and maintaining reputation and brand.
We talked about key themes which face organisations of all kinds, but our guests had a range of health and care sector backgrounds so our focus was largely health and care related. There was universal agreement that whilst the introduction of criminal sanctions which could involve significant fines or imprisonment had served to concentrate the mind, particularly at Board level, they were not changing fundamental provider behaviours because providers already cared far more about the impact of effective quality on their patients and would continue to work to avoid association with poor care at all costs. No-one wants to let a patient or service user down.
Among the key themes discussed we noted that:-
- Regulatory inspection reports are now widely reviewed by organisations' stakeholders – banks, insurers, shareholders, suppliers as well as clients. Those stakeholders want to be associated with providers with high standards, not poor ones, so the ripple effect of a good or bad inspection is significantly wider than the provider itself.
- The impact of social media when critical incidents occur is still an emerging management issue. There is a need to create the right balance between a thriving social media context for an organisation and a social media policy which affords management some appropriate control when organisational reputation is at stake.
- Establishing and rehearsing critical incident protocols so that there is clarity of responsibility and purpose if an incident does occur, can make a significant difference to the ability to retain control of the episode in the face of inevitable media scrutiny
- The impact of an overlapping regulatory environment with a plethora of regulatory stakeholders is making operations complex and carries a significant cost beyond inspection fees. Some organisations are now employing teams whose entire purpose is to prepare for and manage inspections. Regulators are sometimes inconsistent in their application of rules to novel models of care and delivery which increases the challenge of delivering consistent high quality care.
- Root Cause Analysis investigations are an essential tool for learning and embedding remedial action plans, but in a context where litigation may arise they are an key source of information. It is imperative, therefore, that investigations are undertaken pursuant to clear and specific terms of reference by suitably qualified and experienced individuals;
- The involvement of police authorities in critical incident investigation in health and care environment is evolving . It was felt that its impact can be a particularly blunt instrument with the workforce at a time when transparency is a key factor in successful investigation. Experienced advisors will be able to share best practice to help organisations navigate their options without destabilising their entire workforce.
- Many recent high-profile critical incidents have been rooted in failures of leadership. Protecting patient safety is an essential part of risk management and must be led by Boards. Failure to view patient safety as a key business risk in Board decisions can have catastrophic results.
The desire to serve the patient with the highest quality care and outcomes was universal. The complexity of establishing and maintaining a robust reputation or brand, particularly in the complex world of integration and new models of care was self-evident.