High Reliability and Informatics Tools: PKC Software in Primary Care

Growing concern about patient safety and healthcare quality has led some to borrow principles of reliability from industries with exceptional records of safety and reliability. Enhancing the quality of clinical decisions is fundamental to quality improvement. This paper argues that commitment to reliability enables the effective deployment of informatics tools that are, in turn, essential for elevating the reliability and quality of clinical decisions. To illustrate, it describes the use of “knowledge coupling” decision support tools in an innovative family practice committed to high reliability. The tools thoroughly define patients’ complexity, couple this complexity with formal knowledge, and present a range of options available to guide decisions. This investigation shows how informatics tools embedded within a high reliability organization can enhance the reliability of the decision making process, and improve the quality of healthcare decisions. Keywords-Clinical decision support systems; high reliability organizations; informatics; primary health care;