Failures as Opportunities

Luis SaldanaHIMSS Clinical Informatics Insights

"My great concern is not whether you have failed, but whether you are content with your failure."--Abraham Lincoln

In healthcare, business is never routine.  We are dealing with people’s health and lives day in and day out.  I have been an Emergency Physician for 28 years and have learned that the seemingly routine can sometimes lull us into a false sense of security and play into the biases inherent to human decision-making.  And we have seen that this can have significant and meaningful implications.  The delivery of healthcare is inherently complex, and as informaticists we need to factor this complexity into the technologies we build and deploy technologies to support this care.

As the CMIO at Texas Health Resources, I have experienced these challenges along great successes with the teams I serve alongside.  Our patients expect, and deserve, that each and every person involved in designing and delivering their care is diligently committed to doing their best to ensure safe and reliable outcomes.  This includes those of us in health IT. We are called on to deliver always available, well designed integrated, efficient technologies and information to the clinicians delivering care at the bedside.

There have been highly visible cases in the press in the last year that brings attention to the importance of these technologies; to the delivery of safe and effective patient centered care.  Any failure, big and small, need to be seen as calls for continuous improvement in all of healthcare to raise the bar on how we approach and evaluate incidents and design of these systems.  Sittig and Singh describe an 8 dimensional model within complex adaptive healthcare systems to evaluate and address these sociotechnical challenges. 

High reliability organizations (HRO) are organizations who see failure as a window to achieving highly reliable outcomes.  These failures should focus us on how we diligently surveil for, and respond to failures from a patient safety and HRO perspective. We can look at failures as opportunities to learn as informatics teams and organizations. 

It is our calling as informaticists to work tirelessly to work collaboratively with our teams and organizations as well as with our informatics peers to create a vision to improve daily in our efforts to support the mission of delivering best care for every patient every time.  It is a high calling, but one I embrace and enjoy.  Thank you all for accepting this challenge and lets work together to get better for those we serve each and every day.

About the Contributor
Dr. Saldana is the Chief Medical Informatics Officer for Texas Health Resources, one of the largest faith-based, nonprofit health care delivery systems in the United States. In this role, he guides and leads strategic initiatives to leverage Information Technology to improve care delivery and implement, optimize the clinical effectiveness of THR’s Epic Electronic Health Record, CareConnect. In 2013, Texas Health Resources was recognized by HIMSS with the HIMSS Enterprise Davies Award for outstanding achievement in utilizing health information technology to improve patient outcomes and to achieve ROI. Dr. Saldana was recognized by Becker’s Healthcare in 2014 as one of “25 CMIOs to Watch”.

Dr. Saldana is a graduate of University of Texas Southwestern Medical School, and received his MBA from Southern Methodist University’s Cox Business School.  He is a practicing Emergency Physician for over 25 years, and a Fellow of the American College of Emergency Physicians. He also holds an appointment as Adjunct Professor of Healthcare Leadership and Management at the Jindal School of Management, University of Texas at Dallas.