Reliability theory — a scientific method of evaluating, calculating, and improving the overall reliability of a complex system — has been embraced by and used effectively in industries such as manufacturing, nuclear power, and aircraft carriers to improve the rate at which a system consistently produces appropriate outcomes and prevents adverse events.
Clearly, health care is not like manufacturing. In its 1999 report on medical errors, To Err Is Human, the Institute of Medicine (IOM) notes that health care differs from a systematic production process “mostly because of huge variability in patients and circumstances, the need to adapt processes quickly, the rapidly changing knowledge base, and the importance of highly trained professionals who must use expert judgment in dynamic settings.”
But the IOM also notes that other endeavors that are as complex, fluid, and high-risk as providing health care benefit from the application of reliability principles. The report cites nuclear aircraft carriers as “an example of organizational performance requiring nearly continuous operational reliability despite complex interrelated patterns among many people.” Applying reliability theory to health care has the potential to help reduce “defects” in care or care processes, increase the consistency with which appropriate care is delivered, and improve patient outcomes.
