Improving long-term care services: insights from high-reliability organizations

Leadersh Health Serv (Bradf Engl). 2021 Nov 23;ahead-of-print(ahead-of-print). doi: 10.1108/LHS-07-2021-0064.


Purpose: Long-term care (LTC) organizations have struggled to protect their vulnerable clients from the ravages of the COVID-19 pandemic. Although various suggestions on containing outbreaks in LTC facilities have gained prominence, ensuring the safety of residents is not just a crisis issue. In that context, the authors must reasses the traditional management practices that were not sufficient for handling unexpected and demanding conditions. The purpose of this paper is to suggest rethinking the underlying attributes of LTC organizations and drawing insight from the parallels they have to high-reliability organizations (HROs).

Design/methodology/approach: The authors analyzed qualitative data collected from a Canadian LTC facility to shed light on the current state of reliability practices and culture of the LTC industry and to identify the strengths and weaknesses of the traditional management approaches.

Findings: To help the LTC industry develop the necessary crisis management capacity to tackle unexpected future challenges, there is an urgent need for adopting a more systemic top-down approach that cultivates mindfulness, learning and resilience.

Originality/value: This study contributes by applying the HRO theoretical lens in the LTC context. The study provides the LTC leaders with insights into creating a unified effort at the industry level to give rise to a high-reliability-oriented industry.

Keywords: High-reliability organizations; Long-term care; Mindfulness; Qualitative research.

MeSH terms

  • COVID-19*
  • Canada
  • Humans
  • Long-Term Care*
  • Pandemics
  • Reproducibility of Results
  • SARS-CoV-2