Reliabillity & Sustainability

Read here for a brief overview of Reliability & Sustainability. For a more detailed explanation please go to the Education Module.

Reliability is the way to ensure that your healthcare improvement delivers day in and day out. It is failure free operation over time. Reliable processes improve outcomes for patient. They occur by design, not as a result of a happy accident.

If 90% of surgical patients get their prophylactic antibiotic within an hour of surgical incision, the reliability of that process as measured by defect rate is 10-1. Although a percentage is applied, from the patient’s perspective it is an all or nothing process. It is of little comfort to the patient that a system has a reliability of 90% if you are the 1 patient in 10 who does not receive their prophylactic antibiotics in a timely fashion.

Some researchers estimate that most people, under work and time pressures, make errors at the rate of 10-2 even when doing their best work. To be highly reliable, systems must be designed to compensate for the limits of human ability.

Sustainability is achieved when new ways of working and improved outcomes become the norm. Recent literature suggests that up to 70% of organisational change fails of survive. Given that all improvement projects require a big commitment in terms of resources, time and leadership effort this is not acceptable. The NHS Sustainability Model was developed to combat this. The model is a tool to predict the likelihood of sustainability of local improvement projects. It can guide teams to things they could do to increase the chances that the change for improvement will be sustained.